Abstract:The relationships between hospital Magnet 1 status, nursing unit staffing, and patient falls were examined in a cross-sectional study using 2004 National Database of Nursing Quality Indicators (NDNQI 1 ) data from 5,388 units in 108 Magnet and 528 non-Magnet hospitals. In multivariate models, the fall rate was 5% lower in Magnet than non-Magnet hospitals. An additional registered nurse (RN) hour per patient day was associated with a 3% lower fall rate in ICUs. An additional licensed practical nurse (LPN) or nursing assistant (NA) hour was associated with a 2-4% higher fall rate in non-ICUs. Patient safety may be improved by creating environments consistent with Magnet hospital standards. ß

A triangulation approach was used to examine the reliability of the National Database of Nursing Quality Indicators pressure ulcer indicator that included direct observation of these wounds in hospitalized patients and web-based testing with and without accompanying wound descriptions. Overall κ coefficients for pressure ulcer identification, staging, and origin indicate moderate to near perfect reliability and suggest that web-based testing can estimate the reliability of pressure ulcer staging from direct observation. Nurse certification in wound care and wound descriptors improved reliability levels.