As dotações de enfermagem e segurança dos cuidados de saúde: o impacto na mortalidade hospitalar

Objective: To identify the association between exposure to hours of nursing care and hospital mortality. Methodology: The investigation in the quantitative, descriptive paradigm of a sample with 70,241 cases collected in the databases of the System of Classification of Patients in Nursing and Groups of Homogeneous Diagnostics of Portugal, between January 1, 2011 and December 31, 2013. In the treatment of data, a univariate and bivariate analysis of the data was performed using risk measures, with a 95% confidence interval and logistic regression models. Results: On average, each unit classified 26 patients per day in the SCD / E, with a mean of 5.6 HCN / DI, there is a daily deficit of more than 2 hours of care per patient per day, it was observed 2,5 hours deficit in medical units and reaching a daily average of more than fifty negative hours in 56% of the units. The female sex, the above-average age, hospitalization in medicine, urgent admission, the Charson index above 2 and the hospital level III, present a higher risk of increased mortality. We found that patients exposed to a greater deficit of hours of care present a three-fold higher risk of mortality (OR = 3.12, 95% CI 2.17-4.48). Conclusion: The risk of mortality increases (up to) 20% when there is a greater deficit of hours of nursing care.