The Impact of Staffing on Patient Outcomes Across Specialty Units

Whitman, Gayle R.; Kim, Yookyung; Davidson, Lance A.; Wolf, Gail A.; Wang, Shiaw-Ling

doi:10.1097/00005110-200212000-00008

Cited by 110 publications

(74 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2,7,[11][12][13][14][15] The findings of this study show that continued research in this area is needed to explore possible relationships.…”

Section: Discussionmentioning

confidence: 99%

“…11 Yet, despite these known potential complications, physical restraint use in critical care environments continues both internationally and in the United States. 2,[11][12][13] Published reports show that it is the nurses who decide whether or not to restrain a patient with a physician's verbal order often obtained after physical restraints have been applied, if at all. 14 In looking at various factors that can influence this decision, no consensus is apparent in the research findings to support a relationship between staffing, experience level, education level, nurses' attitudes toward use of physical restraints, and practice issues related to use of physical restraints (ie, nurses' actions while caring for patients who are restrained).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Nurses’ Attitudes, Clinical Experience, and Practice Issues With Use of Physical Restraints in Critical Care Units

Stinson

2016

American Journal of Critical Care

View full text Add to dashboard Cite

Background Physical restraints are more likely to be used in critical care units than in other hospital units because use of invasive procedures and mechanical ventilation is more common in critical care units. Initiation and maintenance of physical restraint devices is largely a nursing responsibility. Previous clinical experience is a variable often suggested to be related to intensive care nurses’ use of physical restraints. Objective To examine the relationships between registered nurses’ clinical experience, their practice issues (nurses’ actions while caring for patients who are physically restrained), and their attitudes toward the use of physical restraints (feelings about use of restraints and about caring for patients who are restrained) in critical care units. Methods In a descriptive correlational study, data were collected online via the Physical Restraint Questionnaire. Participants’ (n = 413) clinical experience was classified by using Patricia Benner’s novice to expert framework. Results No strong correlation was found to explain any variance between attitudes toward use of physical restraints in critical care and clinical experience in nursing in general, clinical experience in critical care, and nursing practice issues with use of physical restraints. However, nurses with more clinical experience were more likely to have learned about use of physical restraints in their basic nursing curriculum. Conclusions The reported lack of content addressing use of physical restraints in today’s nursing curricula is a concern, as physical restraints are commonly used in critical care units.

show abstract

“…2,7,[11][12][13][14][15] The findings of this study show that continued research in this area is needed to explore possible relationships.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Nurses’ Attitudes, Clinical Experience, and Practice Issues With Use of Physical Restraints in Critical Care Units

Stinson

2016

American Journal of Critical Care

View full text Add to dashboard Cite

show abstract

“…Nurse demand methods for staffing and nursing workload (which may not be incorporated in the staffing methodology) have come under particular scrutiny (12). Patient/nurse ratios, although a relatively crude measure, are easily determined and have been linked to several adverse patient occurrences in the ICU, including nosocomial infections, falls, medication errors, and postoperative respiratory and cardiac complications (13)(14)(15). Associations between nurse staffing and UE have been less evident (16 -18), although one recent pediatric study concluded that an UE was more likely to occur when a nurse was assigned two patients rather than one (19).…”

mentioning

confidence: 99%

Association of nursing workload and unplanned extubations in a pediatric intensive care unit*

Ream¹,

Mackey²,

Leet³

et al. 2007

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…21,22 The results of several studies support these ideas: more frequent interruptions are associated with more errors, 23 and having more nurses on staff is associated with fewer errors. 24 Use of signage and checklists may minimize distractions during critical phases of administration and may reduce errors overall. 25 For higher risk medications, having a second nurse or pharmacist provide a double check on the medication may also be beneficial.…”

Section: Nursing Interventionsmentioning

confidence: 99%

Safety Recommendations for Administering Intravenous Prostacyclins in the Hospital

Kingman

Chin²

2013

Critical Care Nurse

View full text Add to dashboard Cite

P ulmonary arterial hypertension (PAH) is a rare disease characterized by vasoconstriction and proliferation of the small pulmonary arteries, changes that eventually lead to right-sided heart failure and death in most patients who have the disease. 1 When PAH is diagnosed early in the course of the disease, initial treatment usually consists of oral therapy, including phosphodiesterase type 5 inhibitors and endothelin receptor antagonists.2 Intravenous epoprostenol sodium (Flolan), epoprostenol for injection (Veletri), and treprostinil (Remodulin) are intravenous prostacyclins given as continuous infusions in the most advanced cases of PAH.1 Prostacyclins are potent vasodilators, inhibit platelet activation, and have antiproliferative effects on smooth muscle and intimal cells. Intravenous prostacyclins are expensive and require a comprehensive insurance approval process. Once approved, the drugs are commonly started in the hospital at a dose of 1.25 to 2 ng/kg per minute via a dedicated central catheter, and the dose is increased according to the signs and symptoms of PAH Safety Recommendations for Administering Intravenous Prostacyclins in the Hospital MARTHA S. KINGMAN, DNP, FNP-C KELLY CHIN, MD FeatureProstacyclins are a high-risk category of continuous intravenous infusions increasingly used in hospitals to treat advanced pulmonary arterial hypertension, a rare condition characterized by vasoconstriction and vascular proliferation of the pulmonary arteries. Prostacyclins are given in doses of nanograms per kilogram per minute and have a narrow therapeutic dosing range for each patient. Sudden increases or decreases in dose can be life threatening. Previous studies revealed errors in the administration of these high-risk infusions, which in some instances led to serious adverse events, including death. The literature was reviewed for safety measures in administration of high-risk intravenous medications and input was obtained from leading experts in pulmonary arterial hypertension to create a set of safety recommendations for infusion of prostacyclins. (Critical Care Nurse. 2013;33[5]:32-34,36-41) ©2013 American Association of Critical-Care Nurses doi: http://dx.doi. org/10.4037/ccn2013608 This article has been designated for CNE credit. A closed-book, multiple-choice examination follows this article, which tests your knowledge of the following objectives:1. Distinguish between adverse effects of prostacyclins and symptoms of pulmonary artery hypertension 2. Summarize 4 approaches to prevent errors associated with high-risk medications 3. Describe 3 safety recommendations that reduce error during prostacyclin administration and the side effects of the prostacyclin being administered. Dosing is generally highly individualized according to the severity of the disease and how well patients are able to tolerate the side effects of the drug. Common side effects include headache, jaw pain, flushing, nausea, diarrhea, rash, and pain in the extremities.3 Signs and symptoms of PAH include shortness of breath, c...

show abstract

The Impact of Staffing on Patient Outcomes Across Specialty Units

Abstract: Results from this study suggest that the impact of staffing on outcomes is highly variable across specialty units; however, when present, the relationships are inversely related with lower staffing levels, resulting in higher rates of all outcomes.

Cited by 110 publications

References 10 publications

Nurses’ Attitudes, Clinical Experience, and Practice Issues With Use of Physical Restraints in Critical Care Units

Nurses’ Attitudes, Clinical Experience, and Practice Issues With Use of Physical Restraints in Critical Care Units

Association of nursing workload and unplanned extubations in a pediatric intensive care unit*

Safety Recommendations for Administering Intravenous Prostacyclins in the Hospital

Contact Info

Product

Resources

About