5?20: a model of minimum nurse-to-patient ratios in Victoria, Australia

Gerdtz, Marie; Nelson, Sioban

doi:10.1111/j.1365-2934.2006.00657.x

Cited by 52 publications

(40 citation statements)

References 33 publications

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“…From a policy perspective some authors have argued that it is premature to mandate minimum staffing levels ( [Gerdtz and Nelson, 2007], [Lang et al, 2004] and [Mark et al, 2007]). Yet, the literature has demonstrated that the levels of nurse staffing and the skill mix of those nurses in hospitals remain the most persistent and prominent nursing organisational characteristics for predicting patient outcomes ( [Kane et al, 2007a] and [Kane et al, 2007b]).…”

Section: Discussionmentioning

confidence: 99%

The impact of the nursing hours per patient day (NHPPD) staffing method on patient outcomes: A retrospective analysis of patient and staffing data

Twigg

Duffield

Bremner

et al. 2011

International Journal of Nursing Studies

114

112

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BackgroundIn March 2002 the Australian Industrial Relations Commission ordered the introduction of a new staffing method -nursing hours per patient day (NHPPD) -for implementation in Western Australia public hospitals. This method used a "bottom up" approach to classify each hospital ward into one of seven categories using characteristics such as patient complexity, intervention levels, the presence of high dependency beds, the emergency/elective patient mix and patient turnover. Once classified, NHPPD were allocated for each ward. ObjectivesThe objective of this study was to determine the impact of implementing the NHPPD staffing method on 14 nursing-sensitive outcomes: central nervous system complications, wound infections, pulmonary failure, urinary tract infection, pressure ulcer, pneumonia, deep vein thrombosis, ulcer/gastritis/upper gastrointestinal bleed, sepsis, physiologic/metabolic derangement, shock/cardiac arrest, mortality, failure to rescue and length of stay. Design and settingThe research design was an interrupted time series using retrospective analysis of patient and staffing administrative data from three adult tertiary hospitals in metropolitan Perth over a 4-year period. SampleAll patient records (N = 236,454) and nurse staffing records (N = 150,925) from NHPPD wards were included. ResultsThe study found significant decreases in the rates of nine nursing-sensitive outcomes when examining hospital-level data following implementation of NHPPD; mortality, central nervous system complications, pressure ulcers, deep vein thrombosis, sepsis, ulcer/gastritis/upper gastrointestinal bleed shock/cardiac arrest, pneumonia and average length of stay. At the ward level, significant decreases in the rates of five nursing-sensitive outcomes; mortality, shock/cardiac arrest, ulcer/gastritis/upper gastrointestinal bleed, length of stay and urinary tract infections occurred. ConclusionsThe findings provide evidence to support the continuation of the NHPPD staffing method. They also add to evidence about the importance of nurse staffing to patient safety; evidence that must influence policy. This study is one of the first to empirically review a specific nurse staffing method, based on an individual assessment of each ward to determine staffing requirements, rather than a "one-size-fits-all" approach.What is already known about the topic?• Higher nurse staffing levels have been linked with improved patient outcomes.• This evidence has resulted in some states and jurisdictions legislating or mandating nurse staffing.• The available evidence does not provide specific guidelines for nurse staffing, either in terms of the amount of care required or skill mix of the nurses providing care at a unit level. What this paper adds• This study empirically reviews a specific nurse staffing method, based on an individual assessment of each ward to determine staffing requirements, rather than a "one-size-fits-all" approach.• It provides evidence that implementation of the NHPPD staffing method decreased nursingsensi...

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Section: Discussionmentioning

confidence: 99%

The impact of the nursing hours per patient day (NHPPD) staffing method on patient outcomes: A retrospective analysis of patient and staffing data

Twigg

Duffield

Bremner

et al. 2011

International Journal of Nursing Studies

114

112

View full text Add to dashboard Cite

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“…Despite the growing popularity of ratios there is little research evidence on the costs and consequences of their implementation, 33 especially in the ED environment. The appeal of nurse-patient ratios is in their simplicity: they are easy to implement and contraventions are readily identified.…”

Section: Discussionmentioning

confidence: 98%

Ratios and nurse staffing: The vexed case of emergency departments

Wise

Fry

Duffield

et al. 2015

Australasian Emergency Nursing Journal

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“…Entre estos factores tienen importancia las cualidades de los diferentes profesionales con título universitario o no y que atienden pacientes críticamente enfermos. Eso también había sido establecido en Australia (13) donde notaron que no solamente se relacionaba una razón (un número) enfermero/paciente, sino que también las capacidades o cualidades académicas del personal de enfermería (el saber) se evidenciaron como fundamentales para garantizar la calidad de la atención, ya que no solo se estableció una relación con respecto al número de personas que dan atención.…”

Section: Discussionunclassified

“…Actualmente en relación con estos factores contribuyentes se encuentran estudios que apuntan hacia investigaciones relacionadas, con la REP y su relación con la mortalidad en cuidado intensivo y las complicaciones secundarias a la hospitalización (4,6,13,14) .…”

Section: Introductionunclassified

Pacientes por enfermera-auxiliar y presencia de eventos adversos en unidades de cuidados intensivos de Ibague-Colombia

Caicedo¹,

Abril²

2013

eglobal

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RESUMENEl personal necesario para atender pacientes influye en la calidad del servicio y es un indicador de resultados positivos o de eventos adversos durante la atención de pacientes en ambientes hospitalarios.Objetivo: Establecer la relación existente entre el número de pacientes por enfermero(a)s y auxiliares de enfermería y la probabilidad de ocurrencia de eventos adversos durante un turno en tres unidades de cuidado intensivo de la ciudad de Ibague, Colombia.Método: Estudio ecológico, longitudinal, en tres unidades de cuidado intensivo de Ibague-Colombia en 1656 turnos observados.Resultados: Hubo asociación entre la distribución de enfermero(a)s / paciente E/P y la probabilidad de incidencia de mortalidad 1/5. (OR:1.1) IC 95%, paro cardiorrespiratorio.1/5 (OR 1.38) IC 95% Infecciones derivadas de la atención en salud 1/5 (OR: 1.10) IC 95%. Las dos primeras variables se estudiaron como generales debido a la limitación que impuso el subregistro evidenciado durante el tiempo del estudio. Se evidenció como única variable, de las analizadas en el estudio, sensiblemente relacionada con la razón de auxiliares de enfermería / paciente AE/P la incidencia de escaras por decúbito 1/4 (OR:1.272) IC:95% Conclusiones: La razón enfermero(a) / paciente y auxiliar de enfermería / paciente se relacionan con eventos adversos sin significancia estadística, se hace necesario aumentar el número de observaciones y estudios para tener conclusiones sobre el número de pacientes por enfermera disminuyendo el riesgo de EA.

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5?20: a model of minimum nurse-to-patient ratios in Victoria, Australia

Abstract: There is an urgent need for further research that specifically examines relationships between models of staffing, skill mix and quality outcomes.

Cited by 52 publications

References 33 publications

The impact of the nursing hours per patient day (NHPPD) staffing method on patient outcomes: A retrospective analysis of patient and staffing data

The impact of the nursing hours per patient day (NHPPD) staffing method on patient outcomes: A retrospective analysis of patient and staffing data

Ratios and nurse staffing: The vexed case of emergency departments

Pacientes por enfermera-auxiliar y presencia de eventos adversos en unidades de cuidados intensivos de Ibague-Colombia

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