Exploring the relationship between nursing hours per patient day and mortality rate of hospitalised patients in Taiwan

Abstract

According to the results, we suggested the government and managers in Taiwan double the nursing hours per patient day so that the inpatient mortality rate will decline by 1.1%. This might be the optimal nurse configuration that could provide a balance between cost-effectiveness and patient safety.

Acuity, nurse staffing and workforce, missed care and patient outcomes: A cluster‐unit‐level descriptive comparison

“…Our findings on a NHPPD for patients in the general units (mean 2.4) were significantly lower than those found in other studies, where reported mean a NHPPD in general wards varied from 4.7 (Griffiths et al., 2019) to 6.0 (Gray & Kerfoot, 2016; Pappas, Davidson, Woodard, Davis, & Welton, 2015; Pitkäaho et al., 2016). Our results are only consistent with the ones described by Chang, Yen, Chang, and Liu (2017), reporting an average of 2.3 a NHPPD.…”

The effect of nurse staffing on patient‐safety outcomes: A cross‐sectional survey

“…It has been estimated that each additional patient per nurse is associated with a 7% increase in the likelihood of death and failure to rescue (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002), a 10% increase in the proportion of registered nurses (RNs) is associated with a 9.5% decrease in the odds of acquiring pneumonia (Cho, Ketefian, Barkauskas, & Smith, 2003), and a 10% increase in nurses with a bachelor's degree is associated with a decreased likelihood of patient mortality by roughly 7% (Aiken et al., 2014). Similar findings have been found in other studies (Chang, Yen, Chang, & Liu, 2017; Kim & Bae, 2018). The indices of nurse staffing commonly used in studies are the number of nurses (e.g., the nurse‐to‐patient ratio and nursing hours per patient day) and skill mix (e.g., usually defined as the proportion of RNs or percentage of nursing hours provided by RNs) (Jacob, McKenna, & D'Amore, 2015; Twigg, Kutzer, Jacob, & Seaman, 2019).…”

“…It has been estimated that each additional patient per nurse is associated with a 7% increase in the likelihood of death and failure to rescue (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002), a 10% increase in the proportion of registered nurses (RNs) is associated with a 9.5% decrease in the odds of acquiring pneumonia (Cho, Ketefian, Barkauskas, & Smith, 2003), and a 10% increase in nurses with a bachelor's degree is associated with a decreased likelihood of patient mortality by roughly 7% (Aiken et al, 2014). Similar findings have been found in other studies (Chang, Yen, Chang, & Liu, 2017;Kim & Bae, 2018).…”

Inequality of trauma care under a single-payer universal coverage system in Taiwan: a nationwide cohort study from the National Health Insurance Research Database

“…The shortage of the nursing workforce is constant in Taiwan. When measured by nursing hours per patient day (NHPPD), Taiwan averages 5.19 hours, which is very likely to be overestimated, whereas the American Nurses Association suggests that the minimal requirement for the NHPPD is 6 hours for medical and surgical ward nurses 23 24. According to another more intuitive measurement, the patient–nurse ratio, the average in Taiwan is approximately nine patients to one nurse,25 but the ratio mandated by California legislation is no more than five medical or surgical patients per nurse 26.…”