Background: 

Many inpatient healthcare institutions' nurse staffing plans systematically assign fewer patients to nurses when patient acuity is high, but the impact of this strategy on components of nurse stress has not been thoroughly investigated.

Purpose: 

To examine the relationship between nurse-to-patient ratio assigned based on NICU patient acuity with the Nurse Stress Scale (NSS) subscales Death and Dying, Conflict with Physicians, Inadequate Preparation, Lack of Support, Conflict with Other Nurses, Work Load, and Uncertainty Concerning Treatment.

Methods: 

A survey including the NSS tool items, demographic questions, and a question about nurse-to-patient ratio during the shift was administered. Cronbach's α, linear regression, and Spearman's correlation were used for data analysis.

Results: 

Analysis of the 72 participating NICU nurses' survey responses showed fewer patients per nurse during the shift was negatively correlated with stress related to Death and Dying (P < .001) and Uncertainty Concerning Treatment (P = .002) subscale scores. This inverse relationship remained significant after controlling for education and years of experience.

Implications for Practice: 

The observed higher stress can be inferred to be due to high patient acuity since fewer patients are assigned to nurses caring for high-acuity patients. Improvements in communication to nurses about patients' medical condition, treatment rationale, and information that should be conveyed to the family could reduce nurse stress from treatment uncertainty. Targeted education and counseling could help nurses cope with stress due to patient deaths.

Implications for Research: 

Interventions to reduce stress related to treatment uncertainty and death of patients among NICU nurses caring for high-acuity infants should be developed and evaluated.

中文翻译：

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每个护士更少的病人并不能抵消与新生儿重症监护病房治疗不确定性和死亡率相关的护士压力增加

背景： 

许多住院医疗机构的护士配置计划在患者敏锐度高时系统地分配较少的患者给护士，但这种策略对护士压力构成的影响尚未得到彻底研究。

目的： 

检查根据 NICU 患者敏锐度分配的护士与患者比率与护士压力量表 (NSS) 子量表死亡和死亡、与医生的冲突、准备不足、缺乏支持、与其他护士的冲突、工作负荷和关于治疗的不确定性。

方法： 

进行了一项调查，包括 NSS 工具项目、人口统计问题以及轮班期间护士与患者比例的问题。Cronbach's α、线性回归和 Spearman 相关性用于数据分析。

结果： 

对 72 名参与 NICU 护士的调查答复的分析表明，轮班期间每位护士的患者较少与死亡和临终压力( P < .001) 和治疗不确定性 ( P = .002) 分量表得分呈负相关。在控制教育和多年经验后，这种反比关系仍然显着。

实践意义： 

观察到的较高压力可以推断是由于患者的敏锐度较高，因为分配给照顾高敏锐度患者的护士的患者较少。改善与护士就患者的医疗状况、治疗原理和应传达给家属的信息进行的沟通，可以减少护士因治疗不确定性而产生的压力。有针对性的教育和咨询可以帮助护士应对患者死亡带来的压力。

研究意义： 

应制定和评估干预措施，以减少与护理高危婴儿的 NICU 护士的治疗不确定性和患者死亡相关的压力。