Nurse Staffing in Acute Care Settings: Research Perspectives and Practice Implications

Clarke, Sean P.

doi:10.1016/s1553-7250(07)33111-5

Cited by 26 publications

(30 citation statements)

References 47 publications

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“…(23) Many pioneers in nurse staffing-outcomes research found an association between nurse staffing, in particular RN staffing, and either lower incidence of adverse events or improved quality outcomes. (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) Two nurse staffing-outcomes studies that appeared in the physician literature moved the discussion beyond the nursing community. In 2001, Needleman, Buerhaus, Mattke, Stewart, and Zelevinsky undertook an extensive study of staffing-outcomes research at the request of the Secretary of Health and Human Services.…”

Section: Staffing-outcomes Researchmentioning

confidence: 99%

Nurse staffing and skill mix patterns: Are there differences in outcomes?

Esparza

Zoller

White

et al. 2012

J of Healthc Risk Manag

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The purpose of this study was to examine the impact on patient outcomes of nurse staffing and registered nurse (RN) skill mix patterns used by medical-surgical units in California hospitals after enactment of nurse-to-patient staffing ratio laws, and determine if there are differences in patient outcomes for conditions that are considered sensitive to nursing care. Results from this study demonstrated an association between total nursing hours per patient day (NHPPD) and two outcomes: urinary tract infections (UTI) and length of stay (LOS). A stronger association was observed between the RN proportions of the total nursing hours of care and the same outcomes. The higher the total NHPPD and RN proportion, the lower the LOS and the lower the odds of hospitalized patients' developing UTI.

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Section: Staffing-outcomes Researchmentioning

confidence: 99%

Nurse staffing and skill mix patterns: Are there differences in outcomes?

Esparza

Zoller

White

et al. 2012

J of Healthc Risk Manag

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“…LPN, NA and contract nurse percent hours measures were constructed similarly. While total nursing HPRD measures the extent of nursing hours available to provide resident care, the percent nursing hours variables characterize the extent to which different staffing expertise may be available on a unit to carry out specific care processes or shift tasks of care 21 . Nursing experience was measured by unit tenure, defined as the number of years RNs LPNs, and NAs had worked on the unit.…”

Section: Methodsmentioning

confidence: 99%

Nurse Workforce Characteristics and Infection Risk in VA Community Living Centers

2015

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Objective To examine effects of workforce characteristics on resident infections in Veterans Affairs (VA) Community Living Centers (CLCs). Data Sources A six-year panel of monthly, unit-specific data included workforce characteristics (from the VA Decision Support System and Payroll data) and characteristics of residents and outcome measures (from the Minimum Data Set). Study Design A resident infection composite was the dependent variable. Workforce characteristics of registered nurses (RN), licensed practical nurses (LPN), nurse aides (NA), and contract nurses included: staffing levels, skill mix and tenure. Descriptive statistics and unit-level fixed effects regressions were conducted. Robustness checks varying workforce and outcome parameters were examined. Principal Findings Average nursing hours per resident day was 4.59 hours (sd = 1.21). RN tenure averaged 4.7 years (sd = 1.64) and 4.2 years for both LPN (sd= 1.84) and NA (sd= 1.72). In multivariate analyses RN and LPN tenure were associated with decreased infections by 3.8% (IRR= 0.962 p<0.01) and 2% (IRR=0.98 p<0.01) respectively. Robustness checks consistently found RN and LPN tenure to be associated with decreased infections. Conclusions Increasing RN and LPN tenure are likely to reduce CLC resident infections. Administrators and policymakers need to focus on recruiting and retaining a skilled nursing workforce.

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“…These include subcategories of policy/legislation (safe staffing, 13,14 health care financing, 15 and increasing funding for nursing education 8,11,16 ), practice environment/organizational attributes/hospital characteristics (nurse skill mix, [17][18][19] evidence-based practice, 20 for-profit vs not-for-profit, 21 manager/supervisor support, 22 and Magnet status 23 ), nursing economics (reimbursement, 24 production function, [25][26][27] and cost/savings 28,29 ), and technology/informatics (use in staffing/scheduling 30 and supports nursing functions 31 ).…”

Section: Institutional Factors Affecting Nurse Staffingmentioning

confidence: 99%

Off-Peak Nurse Staffing

Eschiti¹,

Hamilton

2011

Dimensions of Critical Care Nursing

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The off-peak work environment is important to understand because the risk for mortality increases for patients at night and on the weekend in hospitals. Because critical-care nurses are on duty in hospitals 24 hours a day, 7 days a week, they are excellent sources of information regarding what happens on a unit during off-peak times. Inadequate nurse staffing on off-peak shifts was described as a major problem by the nurses we interviewed. The study reported here contributes the type of information needed to better understand the organization of nursing units and nurse staffing on outcomes.

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Nurse Staffing in Acute Care Settings: Research Perspectives and Practice Implications

Cited by 26 publications

References 47 publications

Nurse staffing and skill mix patterns: Are there differences in outcomes?

Nurse staffing and skill mix patterns: Are there differences in outcomes?

Nurse Workforce Characteristics and Infection Risk in VA Community Living Centers

Off-Peak Nurse Staffing

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