Impact of Medical Surgical Acute Care Microsystem Nurse Characteristics and Practices on Patient Outcomes

This team examined individual and collective effects of unit level nurse workload, staff nurse characteristics and selected risk assessment and preventive intervention processes of care on variance in nursing sensitive outcomes of acute care medical-surgical units. The team found that patient outcomes were predicted by combinations of all elements in their model, including: unit/patient characteristics, nursing workload, registered nurse expertise and clinical processes. Interestingly, they found that falls and falls with injury were predicted by patient characteristics and clinical process variables, but not by nurse expertise. However, hospital acquired pressure ulcer prevalence was predicted by a combination of all elements in the model. Finally, the team also found that unit and patient characteristics and workload could predict medication practice errors and that workload and practice errors predicted medication outcome errors. These findings can guide hospitals in efforts to improve staffing effectiveness and patient safety, reducing medication administration errors and understanding prevalence of facility acquired pressure ulcers. This interdisciplinary team was led by Nancy E. Donaldson, RN, DNSc, FAAN and Carolyn Aydin, PhD, researchers from the Collaborative Alliance for Nursing Outcomes (CALNOC) at the University of California, San Francisco and Cedars-Sinai Medical Center.

The project findings are presented in a research brief on the Robert Wood Johnson Foundation's website.

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Interprofessional collaboration (R2)
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