Safety climate has been shown to be associated with a number of important organizational outcomes. In this study, we take a broad view of safety climate—one that includes not only the development and adherence to safety protocols, but also open and constructive responses to errors—and investigate correlates within the health care industry. Drawing on a random, national sample of hospitals, the results revealed that safety climate predicted medication errors, nurse back injuries, urinary tract infections, patient satisfaction, patient perceptions of nurse responsiveness, and nurse satisfaction. As hypothesized, the relationship between safety climate and both medication errors and back injuries was moderated by the complexity of the patient conditions on the unit. Specifically, the effect of the overall safety climate of the unit was accentuated when dealing with more complex patient conditions.

Objective. To evaluate previous research findings of the relationship between nurse staffing and quality of care by examining the effects of change in registered nurse staffing on change in quality of care. Data Sources/Study Setting. Secondary data from the American Hospital Association (AHA)(nurse staffing, hospital characteristics), InterStudy and Area Resource Files (ARF) (market characteristics), Centers for Medicare and Medicaid Services (CMS) (financial performance), and Healthcare Cost and Utilization Project (HCUP) (quality measures--in-hospital mortality ratio and the complication ratios for decubitus ulcers, pneumonia, and urinary tract infection, which were risk-adjusted using the Medstat s disease staging algorithm). Study Design. Data from a longitudinal cohort of 422 hospitals were analyzed from 1990-1995 to examine the relationships between nurse staffing and quality of care. Data Collection/Extraction Methods. A generalized method of moments estimator for dynamic panel data was used to analyze the data. Principal Findings. Increasing registered nurse staffing had a diminishing marginal effect on reducing mortality ratio, but had no consistent effect on any of the complications. Selected hospital characteristics, market characteristics, and financial performance had other independent effects on quality measures. Conclusions. The findings provide limited support for the prevailing notion that improving registered nurse (RN) staffing unconditionally improves quality of care.

Purpose/Objectives To evaluate the feasibility and acceptability of a newly developed web-based, couple-oriented intervention called Prostate Cancer Education and Resources for Couples (PERC). Design Quantitative, qualitative, mixed-methods approach. Setting Oncology outpatient clinics at the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center at UNC–Chapel Hill. Sample 26 patients with localized prostate cancer (PCa) and their partners. Methods Pre- and postpilot quantitative assessments and a postpilot qualitative interview were conducted. Main Research Variables General and PCa-specific symptoms, quality of life, psychosocial factors, PERC's ease of use, and web activities. Findings Improvement was shown in some PCa-specific and general symptoms (small effect sizes for patients and small-to-medium effect sizes for partners), overall quality of life, and physical and social domains of quality of life for patients (small effect sizes). Web activity data indicated high PERC use. Qualitative and quantitative analyses indicated that participants found PERC easy to use and understand, as well as engaging, of high quality, and relevant. Overall, participants were satisfied with PERC and reported that PERC improved their knowledge about symptom management and communication as a couple. Conclusions PERC was a feasible, acceptable method of reducing the side effects of PCa treatment–related symptoms and improving quality of life. Implications for Nursing PERC has the potential to reduce the negative impacts of symptoms and enhance quality of life for patients with localized PCa and their partners, particularly for those who live in rural areas and have limited access to post-treatment supportive care.

IMPORTANCE Quality improvement initiatives demonstrate the contribution of reliable nursing care to gains in clinical and safety outcomes in neonatal intensive care units (NICUs); when core care is missed, outcomes can worsen.OBJECTIVE To evaluate the association of NICU nurse workload with missed nursing care. DESIGN, SETTING, AND PARTICIPANTSA prospective design was used to evaluate associations between shift-level workload of individual nurses and missed care for assigned infants from March 1, 2013, through January 31, 2014, at a 52-bed level IV NICU in a Midwestern academic medical center. A convenience sample of registered nurses who provided direct patient care and completed unit orientation were enrolled. Nurses reported care during each shift for individual infants whose clinical data were extracted from the electronic health record.

We found that professional nursing practice had consistent effects across model levels on nursing satisfaction, but very limited effects on other outcomes. Important differences in the hospital- and nursing unit level models support continued use of multilevel modeling techniques in the study of organizational and patient outcomes.