26 hours ago Agency for Healthcare Research and Quality (US), Archive [Internet]. 2007 Mar [cited 2013 Jan 15]. Nurse Staffing and Quality of Patient Care Evidence Reports/Technology Assessments, No. 151 Investigators: Robert L Kane, MD, Tatyana Shamliyan, MD, MS, Christine Mueller, PhD, RN, Sue Duval, PhD, and Timothy J Wilt, MD, MPH. >> Go To The Portal
Observational studies were reviewed to examine the relationship between nurse staffing and outcomes. Meta-analysis tested the consistency of the association between nurse staffing and patient outcomes; classes of patient and hospital characteristics were analyzed separately.
To determine the impact of unit-level nurse staffing on quality of discharge teaching, patient perception of discharge readiness, and postdischarge readmission and emergency department (ED) visits, and cost-benefit of adjustments to unit nurse staffing. Data Sources
A cost-benefit analysis of modifying nurse staffing was performed for the two staffing variables with significant impact on postdischarge utilization.
The panel data analysis revealed that in the months of the study when nursing units had higher RN nonovertime staffing, the odds of patient readmission were lower.
To assess how nurse to patient ratios and nurse work hours were associated with patient outcomes in acute care hospitals, factors that influence nurse staffing policies, and nurse staffing strategies that improved patient outcomes.
MEDLINE (PubMed), CINAHL, Cochrane Databases, EBSCO research database, BioMed Central, Federal reports, National Database of Nursing Quality Indicators, National Center for Workforce Analysis, American Nurses Association, American Academy of Nurse Practitioners, and Digital Dissertations.
Higher registered nurse staffing was associated with less hospital-related mortality, failure to rescue, cardiac arrest, hospital acquired pneumonia, and other adverse events. The effect of increased registered nurse staffing on patients safety was strong and consistent in intensive care units and in surgical patients.
Increased nursing staffing in hospitals was associated with lower hospital-related mortality, failure to rescue, and other patient outcomes, but the association is not necessarily causal.
A commitment to a high quality care at hospital level may provide better patient outcomes in relation to nurse staffing. Strength of the Evidence . Taken as a whole, there is consistent evidence of an association between the level of nurse staffing and patient outcomes but no clear case for causation.
A few studies suggest that LPN/LVN hours may increase the rates of sepsis, shock, urinary tract infections, and hospital inquired pneumonia in surgical patients. Additional UAP hours reduced the rate of pressure ulcers, patient falls, and urinary tract infection but not other outcomes.