APN排班模式对临床护理工作影响的Meta分析

Effectiveness of APN scheduling model in clinical nursing work:a Meta-analysis

目的:评价APN排班模式对临床护理工作满意度和工作质量的影响。方法:采用计算机检索CNKI、VIP和万方数据库中所有APN排班模式对临床护理工作影响的随机对照试验(RCT)、类实验性研究,检索时限为2006年1月至2013年12月。按纳入、排除标准由两名筛选员进行独立评价后,采用RevMan 5.1软件进行Meta分析。结果:共纳入2项RCT和10项类实验性研究。Meta分析结果显示,APN排班组患者、医生对护理工作满意度及护士对排班的满意度较传统排班组高,差异有统计学意义[OR=6.63,95%CI(4.59,9.58),P<0.00001;OR=3.32,95%CI(1.78,6.18),P=0.0002;OR=4.98,95%CI(2.29,10.85),P<0.0001];APN排班能提高护理管理、基础护理、护理文书、消毒隔离技术的质量,合并效应有统计学意义[SMD=2.72,95%CI(0.21,5.42),P=0.03;SMD=2.28,95%CI(1.43,3.13),P<0.00001;SMD=1.36,95%CI(1.01,1.72),P<0.00001;SMD=3.19,95%CI(0.74,5.63),P=0.01]。结论:APN排班模式对于提高护理工作满意度及工作质量具有一定效果,但今后仍需要标准化的测量工具和高质量的RCT进一步验证。

Objective： To evaluate the effectiveness of APN scheduling model in clinical nursing work. Methods： The randomized controlled trials（RCTs） and quasi-experimental studies about APN scheduling model in clinical nursing work were collected through the databases such as CNKI,VIP and Wanfang Data from January 2006 to December 2013.The quality of studies was critically appraised and data were extracted by two reviewers independently, and Meta-analysis was performed for the included studies by the Review Manager 5.1 software（RevMan 5.1）. Results： Two RCTs and 10 quasi-experimental studies involving 6050 patients,436 doctors and 1456 nurses were included.Meta-analysis showed that compared with traditional scheduling model, APN scheduling model could improve the satisfaction degree of patients and doctors towards to clinical nursing work and nurses＇ satisfaction degree of scheduling model,and the difference was statistically significant [OR=6.63, 95% CI（4.59, 9.58）, P〈0.00001; OR=3.32, 95% CI（1.78,6.18）, P=0.0002; OR=4.98, 95% CI（2.29, 10.85）, P〈0.0001]. APN scheduling model could improve the quality of nursing management,primary care,nursing documents and disinfection Work,and the combined effect was statistically significant [SMD=2.72, 95% CI（0.21, 5.42）, P=0.03; SMD=2.28, 95% CI（1.43, 3.13）, P〈0.00001; SMD=1.36, 95% CI（1.01, 1.72）, P〈0.00001; SMD=3.19, 95% CI（0.74, 5.63）, P=0.01]. Conclusions： APN scheduling model could improve the satisfaction degree and the quality of clinical nursing work to some extent.However,the standardized measurement tools and high-quality RCTs are still needed.