Nursing Care Quality in Acute Care Hospitals: New Linkages to Patient Outcomes

Led by Arlyss Anderson Rothman and R. Adams Dudley, a team at the University of California, San Francisco examined whether increases in nurse staffing and skill mix improve hospital performance on a subset of Joint Commission core measures, enhance patient perceptions of nursing performance, and improve overall nursing performance as measured by composite indicators that capture patients' perceptions of care and other selected outcomes of care such as complication rates. Researchers found that, for measures in which nurses were dependent on the actions of others (such as pneumonia vaccination screening and the delivery of beta-blockers on arrival for acute myocardial infarction patients) or shared responsibility with others (such as pressure ulcer prevalence) the impact of nurse staffing on performance was mixed. However, when patients were asked about aspects of care in which nurses functioned independently, there were more consistent, statistically significant correlations between patients' assessments of the quality of their hospital care and nurse staffing. This work comes at an important time as increased public reporting of hospital performance and the emergence of hospital pay-for-performance initiatives provide new impetus to define all aspects of hospital care.

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Health care workforce data (R8)
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