Background: Nurse staffing levels are an important working condition issue for nurses and believed to be a determinant of the quality of nursing care and patient outcomes. Objectives:To examine the effects of nurse staffing on adverse events, morbidity, mortality, and medical costs. Methods:Using two existing databases, the study sample included 232 acute care California hospitals and 124,204 patients in 20 surgical diagnosis-related groups. The adverse events included patient fall/injury, pressure ulcer, adverse drug event, pneumonia, urinary tract infection, wound infection, and sepsis. Multilevel analysis was employed to examine, simultaneously, the effects of nurse staffing and patient and hospital characteristics on patient outcomes.Results: Three statistically significant relationships were found between nurse staffing and adverse events. An increase of 1 hour worked by registered nurses (RN) per patient day was associated with an 8.9% decrease in the odds of pneumonia. Similarly, a 10% increase in RN Proportion was associated with a 9.5% decrease in the odds of pneumonia. Providing a greater number of nursing hours per patient day was associated with a higher probability of pressure ulcers. The occurrence of each adverse event was associated with a significantly prolonged length of stay and increased medical costs. Patients who had pneumonia, wound infection or sepsis had a greater probability of death during hospitalization. Conclusion:Patients are experiencing adverse events during hospitalization. Care systems to reduce adverse events and their consequences are needed. Having appropriate nurse staffing is a significant consideration in some cases.

The purpose of this study was to ascertain the interest by executives of major corporations in having occupational health nurses engage in more advanced activities, and to ascertain the available support for advanced educational preparation for nurses. A questionnaire was sent to a systematic sample of 404 of the 808 executives of the Forbes 500 corporations with a 57% return rate. Over 90% of the corporations with health care departments employed registered nurses. Functions nurses currently performed varied by size of the corporation and by type of industry. Activities corporations would like nurses to perform were more advanced, such as conducting research, analyzing trends, and developing special health programs.

An experimental, community-based, residential program, focused on health promotion, was established in 1990 for incarcerated pregnant women with short-term sentences and histories of drug abuse in a large, midwestern metropolitan area in the United States. Infants resided with mothers after birth. Prenatal care, delivery, postpartum, and family-planning services were initiated and provided by a nurse-midwifery service. Community-based health care, job training, and drug rehabilitation were provided for women during pregnancy through the fourth postpartum month. Program participants' prenatal, delivery, postpartum, and neonatal health outcomes are presented and compared with those of incarcerated women in the same state prison system who experienced usual correctional facility care and support. Program participants represented a group of obstetrically high-risk women. Health outcomes for both groups of incarcerated women and their infants were similar and more optimal than would have been expected given their preexisting health conditions and risk factors.

In the current research environment the design and management of control groups is becoming more complex. The selection of a control group design is dependent on study goals, presence and quality of existing interventions, urgency of the problem or issue being addressed by the intervention, and factors related to the study site. The purpose of the presentation is to identify various approaches to the design of control groups in experimental studies and to identify their strengths, limitations, and applications. A case study exemplifies the issues associated with control group selection and design.

The purpose of this study was to determine the effects of public health nurse postpartum home visits by comparing the health outcomes of 67 randomly selected mother-infant pairs who had received such services with 43 randomly selected mother-infant pairs who had not received them. Health outcome variables were mother's health and health services utilization, infant's health and health services utilization, and mother's parenting practices. Data

Exposure to bloodborne pathogens (e.g., HIV, hepatitis B, hepatitis C) through percutaneous injuries is an occupational risk for health care workers, especially those in the OR. The incidence of disease continues to rise, although occupational exposures often go unreported. Percutaneous injury prevention methods have included use of safety devices, practice changes, and educational programs. An educational intervention to increase awareness of risk, provide suggestions for injury reduction, and encourage reporting of exposures was performed at a university teaching hospital. Preliminary qualitative results show increased exposure reporting, increased use of personal protective equipment, and increased awareness of disease exposure risk among OR personnel.

Good to very good quality of care was documented across NMHCs, and NMHCs compared favorably with national benchmarks. Data were useful to NMHCs in identifying quality strengths and areas for improvement. National data collection proved to be feasible.

The use of outcome measures that are more sensitive and responsive to nursing are more effective in guiding nursing practice.