Nurse Staffing Effects on Patient Outcomes: Safety-Net and Non-Safety-Net Hospitals

Date: 04/01/2011
http://journals.lww.com/lww-medicalcare/Abstract/2011/04000/Nurse_Staffing_Effects_on_Patient_Outcomes_.13.aspx
Author(s): Mary Blegen, Colleen Goode, Joanne Spetz, Thomas Vaughn, Shin Hye Park

 

BACKGROUND: Nurse staffing has been linked to hospital patient outcomes; however, previous results were inconsistent because of variations in measures of staffing and were only rarely specific to types of patient care units.

OBJECTIVE: To determine the relationship between nurse staffing in general and intensive care units and patient outcomes and determine whether safety net status affects this relationship.

RESEARCH DESIGN: A cross-sectional design used data from hospitals belonging to the University HealthSystem Consortium.

SUBJECTS: Data were available for approximately 1.1 million adult patient discharges and staffing for 872 patient care units from 54 hospitals.

MEASURES: Total hours of nursing care [Registered Nurses (RNs), Licensed Practical Nurses, and assistants] determined per inpatient day (TotHPD) and RN skill mix were the measures of staffing; Agency for Healthcare Research and Quality risk-adjusted safety and quality indicators were the outcome measures.

RESULTS: TotHPD in general units was associated with lower rates of congestive heart failure mortality (P

CONCLUSIONS: Higher nurse staffing protected patients from poor outcomes; however, hospital safety-net status introduced complexities in this relationship.

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