hospital nurse staffing and patient outcomes: a report to the minnesota legislature

MDH report on hospital nurse staffing and patient outcomes As part of the Nurse Staffing Plan Disclosure Act, the Minnesota Legislature directed the Minnesota Department of Health (MDH) to study the correlation between nurse staffing levels and patient outcomes.

Full Answer

Does California’s nurse staffing legislation impact patient outcomes?

It is possible that some longitudinal studies at the unit or hospital level, such as those that failed to find a beneficial impact of California’s nurse staffing legislation [5, 6], were not able to detect the impact of changes in staffing on patient outcomes because of large within-unit variability in the outcomes.

Does nurse staffing affect patient outcomes?

Also, there was no control for patient risk, however, we would expect risk to average out to a large extent in aggregation. The analyses were designed to examine temporal associations between nurse staffing and patient outcomes in aggregate, not at hospital or unit level.

Which states require public reporting of hospital staffing data?

Five of the eight states (Illinois, New Jersey, New York, Rhode Island, and Vermont) mandated public reporting, and Illinois also mandated hospitals have staffing committees composed of at least 50% direct-care nurses (Nurse Staffing by Patient Acuity Act, 2008).

Should nurse staffing levels be public information?

Public reporting or public disclosure of nurse staffing patterns aims to incentivize hospitals to improve staffing by making comparison data available for consumers as well as nurses and hospital administrators. Currently, eight states in the United States publicly report and disclose information on nurse staffing levels to the public.

How long do you have to be hospitalized to complete a nurse survey?

Patients must be cognitively and physically able to complete the survey and have been hospitalized for 3 days or longer. Measures: The nurse survey includes the internationally validated Practice Environment Scale of the Nursing Work Index to measure the quality of the nurse work environment (32).

Which countries have nurse staffing standards?

Based upon the establishment of a link between lower patient to nurse ratios and better patient outcomes, a number of jurisdictions and countries have adopted safe nurse staffing standards including California in the U.S., Victoria and Queensland in Australia, Ireland, and Wales.

What is the quality health outcomes model?

This model is an elaboration and extension of Donabedian's (28) essentially linear conception of quality that structure affects processes, which in turn affects outcomes. The Quality Health Outcomes Model posits that the effects of interventions are mediated by client and system characteristics; no independent direct effect on outcomes is assume, as depicted in Figure 3. Relationships specified by the QHOM are consistent with observations that there are far more nursing and medical interventions that have been shown to be successful under controlled conditions to improve patient outcomes but do not have their intended effects once introduced into usual practice conditions. Our 25 years of research has amassed substantial evidence that modifiable “system” features such as patient to nurse staffing ratios, nursing workforce skill mix, the composition of the RN workforce by educational qualifications, and the quality of the work environment mediate the outcomes of interventions such as in-hospital resuscitation (29); infection prevention (17); and the rescue of patients experiencing complications in the hospital (12).

What is high patient turnover?

High patient turnover contributes to increased demands and stresses resources for care. In this study, the authors evaluated how nurse staffing and failure-to-rescue (FTR) varied with patient turnover.

What is RN4cast?

The Registered Nurse Forecasting (RN4CAST) study was a worldwide effort to not only quantify the number of professional nurses but to determine the quality of nursing staff on patient outcomes. In this seminal research, the authors assessed whether “differences in patient to nurse ratios and nurse educational qualifications in nine of the 12 RN4CAST countries with similar patient discharge data were associated with variation in hospital mortality after common surgical procedures.” Aiken, L.H., Sloane, D.M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R.,… Sermeus, W. (2014, May 24). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet, 383 (9931), 1824–1830. Retrieved from: