Nurse staffing effects on patient outcomes: safety-net and non-safety-net hospitals.

Research Topic: 
Research Topic: 
Research Topic: 

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. The objective of this study was 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.

Total hours of nursing care [Registered Nurses (RNs), Licensed Practical Nurses, and assistants] determined per inpatient day (TotHPD) in general units was associated with lower rates of congestive heart failure mortality (P<0.05), failure to rescue (P<0.10), infections (P<0.01), and prolonged length of stay (P<0.01). RN skill mix in general units was associated with reduced failure to rescue (P<0.01) and infections (P<0.05). TotHPD in intensive care units was associated with fewer infections (P<0.05) and decubitus ulcers (P<0.10). RN skill mix was associated with fewer cases of sepsis (P<0.01) and failure to rescue (P<0.05). Safety-net status was associated with higher rates of congestive heart failure mortality, decubitus ulcers, and failure to rescue. Higher nurse staffing protected patients from poor outcomes; however, hospital safety-net status introduced complexities in this relationship.

Citation

Blegen, M.A., Goode, C., Spetz, J., Vaughn T., & Park S.H. (2011). Nurse staffing effects on patient outcomes: safety-net and non-safety-net hospitals. Medical Care. 409: 406-414.

Institution: 
Grantee: 
Dr. Mary Blegen
Grantee: 
Dr. Tom Vaughn
Grant Year: