C'est comme qui dirait assez logique,merci. Ce qui m'�tonne le plus,c'est qu'on fasse des �tudes l�-dessus...
Un peu comme si on faisait une �tude pour savoir si les �l�ves r�ussissent mieux en classe avec un ratio prof/�l�ve de 1:10 ou de 1:60 Y'a des choses qui parlent toutes seules... C. ----- Original Message ----- From: "Charles Brault" <[EMAIL PROTECTED]> To: "URG-L Mailing List" <[EMAIL PROTECTED]> Sent: Thursday, May 30, 2002 10:00 AM Subject: URG-L: La p�nurie d'infirmi�re ! Les patients s'en portent plus mal > > > Shortage of Nurses Hurts Patient Care, Study Finds > By DENISE GRADY > > > In hospitals with low numbers of registered nurses, patients are more > likely to suffer complications like urinary infections and pneumonia, > to stay in the hospital longer and to die from treatable conditions > like shock or gastrointestinal bleeding, researchers report today. > "I estimate that hundreds or, perhaps, thousands of deaths each year > are due to low staffing," said Dr. Jack Needleman, an economist at > the Harvard School of Public Health and the lead author of a study on > staffing published today in The New England Journal of Medicine. > The nation has a serious nursing shortage, with 126,000 jobs > unfilled, 12 percent of capacity, says the American Hospital > Association. The shortage is a result of hospital mergers, layoffs > and heavy workloads. Many hospital nurses shifted to other work. The > average salary, $46,000 a year, has not increased much in a decade. > Even though hospitals are trying to hire again, nurses are no longer > available. > The new study, paid mostly by the government, is one of the largest > to look at care in relation to staffing. The findings were based on a > computer analysis of the discharge records of more than six million > patients at 799 hospitals in 11 states in 1997. Five million had > medical problems. One million had surgery. > The research sought to find out whether there was a correlation > between how patients fared and the levels of registered nurses and > two other types of workers with less training, licensed practical > nurses and aides. > Registered nurses receive several years of training and usually hold > associate's or bachelor's degrees. Practical nurses usually have high > school diplomas and a year of training. Aides have less training. > The researchers found that for certain aspects of care just nurses > made a difference. In hospitals with higher nurse staffing, stays > were 3 to 5 percent shorter, and complication rates 2 to 9 percent > lower than in hospitals with lower staffing. No relation was found > between patients' well-being or length of stay and the levels of > aides or practical nurses. > Registered nurses, Dr. Needleman said, are "the eyes and ears of the > hospital" for judging whether a patient is recovering normally. > "If something is going wrong," he said, "they can catch the signs > early, before the problem gets worse." > But problems cannot be spotted early, he added, if nurses do not have > time to observe their patients. > The president of the American Nurses Association, Mary E. Foley, > said, "We're very pleased that another large set of research data has > validated what the American Nurses Association has been saying since > the mid-90's, that there is a direct effect on the outcome of patient > care when you have enough nurses." > As an example, Ms. Foley said, pneumonia and blood clots in > hospitalized patients often result from immobility, and nurses help > prevent such complications by turning and repositioning bedridden > patients, encouraging them to exercise and cough and helping others > to get up and walk around. Even if nurses themselves do not do those > things for patients, they have the training and experience to know > when such help is needed and to ensure it is provided. > A senior vice president for policy at the American Hospital > Association, Carmela Coyle, said: "The study suggests that registered > nurses are key and critical to insuring good patient care. This is > something that hospitals and patients have known for some time." > Ms. Coyle said she feared that the study would lead some people to > assume that health care problems could be solved by laws that require > specific staffing ratios, a move that hospital trade groups have long > resisted. She called such a reaction overly simplistic. > "What you really need to look at," Ms. Coyle said, "is much more than > the number of nurses and the number of patients. How many of the > nurses have 20 years of experience or more, and how many are right > out of school? What technology is there to support them? How sick are > the patients?" > Dr. Needleman said his group made its study because the government > sought to fill a large research gap on the connection between nurse > staffing and quality of care. In the early 1990's, nurses testified > to Congress that patients in some hospitals were endangered by > managed-care companies that were trying to save money by replacing > registered nurses with less skilled and lower paid workers. Congress > asked the Institute of Medicine to study the issue. In a report in > 1996, the institute said there was not enough data to draw > conclusions and called on the government to finance studies. > Dr. Needleman's is one of those. It measured staffing two ways, by > the proportion of nursing hours provided by each type of worker and > by the number of hours a day the types of workers devoted to each > patient. > For registered nurses, the average number of hours a day per patient > worked out to eight. The hours included not only time spent at the > bedside, but also time spent preparing medication, writing chart > reports and consulting colleagues or family members. > The averages include intensive care units, with one nurse for every > one or two patients around the clock. > "There were some hospitals, that if I were going to them as a > patient, I would be very concerned," Dr. Needleman said. "The > hospitals at the very low end of our sample had as little as two > hours, and some at the high end had 16 hours." > When the study compared the hospitals in the top quarter with those > in the bottom quarter on the proportion of nursing time from > registered nurses, it found that the medical patients, as opposed to > surgical patients, in the bottom quarter had stays 3.5 percent > longer, 9 percent more urinary infections, 5.1 percent more > gastrointestinal bleeding, 6.4 percent more pneumonia and 9.4 percent > more shock or cardiac arrest. > In addition, the death rate was 2.5 percent higher for "failure to > rescue," meaning that the patients died from conditions that might > have been reversed if they had been treated in time. Those conditions > include pneumonia, shock or cardiac arrest, upper gastrointestinal > bleeding, sepsis or a blood clot. > > http://nytimes.com/2002/05/30/health/30NURS.html > > > > __________________________________________________ > Do You Yahoo!? > Yahoo! - Official partner of 2002 FIFA World Cup > http://fifaworldcup.yahoo.com >
