Hospital nurse-staffing models and patient- and staff-related outcomes

Butler, Michelle; Schultz, Tim; Halligan, Phil; Sheridan, Ann; Kinsman, Leigh; Rotter, Thomas; Beaumier, Jonathan; Kelly, Robyn Gail; Drennan, Jonathan

doi:10.1002/14651858.cd007019.pub3

Cited by 58 publications

(53 citation statements)

References 109 publications

(7 reference statements)

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“…The number of CNs and CNSs in the ICU per 10 beds was associated with a 3% reduction in the odds of mechanically ventilated patients dying within 30 days of hospitalization (Morita, Matsui, Yamana, et al, 2017). The number of CNs and CNSs in other specialties was also higher in the PNS ® group, but this may not have influenced patient mortality (Butler et al, 2019). Third, the PNS ® group had a better nurse assistant-to-patient ratio (1:25) than the fixed-team nursing group (1:50).…”

Section: Nursing Models and 30-day Inhospital Mortalitymentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

“…Previous research has not adequately explored the relationship between nursing delivery models and patient or nurse outcomes (Butler et al, 2019;King, Long, & Lisy, 2015). Regarding nurse-related outcomes, Cochrane systematic reviews were unable to confirm an association between the primary nursing model and nurses' turnover and costs (Butler et al, 2019) or one between nursing models (team nursing vs. total patient care) and nurses' wellbeing (King et al, 2015) due to only a small number of well-designed studies. Similarly, there are limited studies on PNS ® , and the few studies that have examined it have focused on nurse-related outcomes: an improvement in communication and collaboration among nurses (Maruoka et al, 2015); a decrease in the perceived burden of high job quality and workload, a reduction in anxiety, and an increase in support from colleagues and job satisfaction (Kamijo, Naganuma, Jinguji, Isobe, & Amemiya, 2015); and a decline in the turnover rate of new graduate nurses (Shimoji, Oshiro, Toguchi, & Kajiki, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Association between nursing care delivery models and patients' health outcomes in a university hospital: A retrospective cohort study based on the Diagnostic Procedure Combination database

Higaonna

Morimoto

Ueda

2020

Japan Journal Nursing Sci

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Aim This study aims to examine the association between nursing delivery models (fixed‐team nursing model and Partnership Nursing System® [PNS®]) and patients' health outcomes (30‐day in‐hospital mortality and functional decline, indicated by a decline in Barthel Index or in‐hospital mortality). Methods This study used a retrospective cohort design based on the data from the Diagnostic Procedure Combination database, which included routinely collected health data for Japanese administrative claims. Participants were inpatients aged 20–99 years admitted between July 2010 and August 2012 (fixed‐team nursing period) and July 2014 and August 2017 (PNS® period) to an academic teaching hospital in Japan. Odds ratios and 95% confidence intervals were estimated using multivariable logistic models. Results We included 24,108 and 23,872 patients for the analyses of 30‐day in‐hospital mortality and functional decline, respectively (median age: 62 years; 52% women). The 30‐day mortalities in both fixed‐team nursing and PNS® groups were 0.5%. There was no significant association between the nursing delivery models and 30‐day in‐hospital mortality (adjusted odds ratio = 1.15, 95% confidence interval = 0.78–1.70). However, the PNS® group was found to have a higher proportion of patients with functional decline (2.7%) than the fixed‐team nursing group (2.2%; p = .030). The adjusted odds ratio of declined function in the PNS® group, compared to the fixed‐team nursing group, was 1.40 (95% confidence interval = 1.17–1.68, p < .001). Conclusions Further studies are needed to examine how the PNS® model influences patient outcomes, especially nurse‐sensitive patient outcomes.

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Section: Nursing Models and 30-day Inhospital Mortalitymentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between nursing care delivery models and patients' health outcomes in a university hospital: A retrospective cohort study based on the Diagnostic Procedure Combination database

Higaonna

Morimoto

Ueda

2020

Japan Journal Nursing Sci

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“…Appropriate nurse staffing levels also allow support staff, such as nurse assistants, to facilitate nurses' role in patient care management (Squires et al, 2015). Nurse staffing models are used to determine the optimal allocation of nursing resources to meet the care needs of patients (Butler et al, 2019;Dubois et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…This mandatory nurse-to-patient ratio determines the number of patients one nurse will provide care for per shift. The mandatory nurse-to-patient ratio in Victoria, Australia, is five nurses to 20 patients (Butler et al, 2019;Gerdtz & Nelson, 2007). The mandatory nurse-to-patient ratio in Victoria, Australia, is five nurses to 20 patients (Butler et al, 2019;Gerdtz & Nelson, 2007).…”

Section: Introductionmentioning

confidence: 99%

Nurse staffing models in medical‐surgical units of acute care settings: A cross‐sectional study

Assaye

Wiechula

Schultz

et al. 2019

Int J of Nursing Practice

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Background: Nurse staffing models have been developed across different countries to address nursing shortages and improve quality of nursing care. However, there is no published study that describes nurse staffing models in Ethiopian hospitals. Aims:To describe the existing staffing models for nursing practice in acute care units of two hospitals (one public and one private) in Ethiopia. Methods:A cross-sectional study was conducted from July to December 2018. A self-administered questionnaire was used to collect data such as shift patterns, hours worked, and number of patients cared for per shift. Unit-level data on nurse staffing were collected using a checklist developed specifically for this study.Results: Fifty-nine percent (59.9%) of participants reported that they worked six or seven days per week. On average, they worked 50 hours per week and 12% working over 60 hours per week. The number of patients they provided care for during their last shift ranged from four to 45 with an average of 13 patients. Conclusion:This study demonstrates that nurses working in acute care settings in Ethiopia are typically working more than 40 hours per week and caring for many patients per shift, which has the potential to impact patient safety. K E Y W O R D Sacute care, Ethiopia, medical-surgical, nurse staffing, nursing, staffing models SUMMARY STATEMENTWhat is already known about this topic?• Nurse staffing is a critical factor affecting patient safety and nurse workforce outcomes.• There are different staffing models in which staff are assigned to give care for patients in different healthcare settings but much of the research is from high-income countries.What this paper adds?• This paper describes nurse staffing in acute care settings in Ethiopia, a low-income country. The number of patients for whom nurses provide care per shift, and the number of hours nurses provide care per week, is very high compared with other settings.• Nurses work very long hours, often more than 50 hours per week.• Many nurses routinely work or seven days per week and on average nurses care for 13 patients per shift

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Interventions to Reduce Hospital Length of Stay in High-risk Populations

et al. 2021

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Key Points Question Which hospital-led interventions are associated with reducing length of stay (LOS) for high-risk populations? Findings In this systematic review including 19 systematic reviews, 8 strategies for reducing LOS in high-risk populations were identified: discharge planning, geriatric assessment, medication management, clinical pathways, interdisciplinary or multidisciplinary care, case management, hospitalist services, and telehealth. Interventions were most frequently designed for older patients or patients with heart failure and were often associated with inconsistent outcomes in LOS, readmissions, and mortality across populations. Meaning This systematic review found that across all high-risk populations, there are inconsistent results on the effectiveness associated with interventions to reduce LOS, such as discharge planning, which are often widely used by health systems.

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Hospital nurse-staffing models and patient- and staff-related outcomes

Cited by 58 publications

References 109 publications

Association between nursing care delivery models and patients' health outcomes in a university hospital: A retrospective cohort study based on the Diagnostic Procedure Combination database

Association between nursing care delivery models and patients' health outcomes in a university hospital: A retrospective cohort study based on the Diagnostic Procedure Combination database

Nurse staffing models in medical‐surgical units of acute care settings: A cross‐sectional study

Interventions to Reduce Hospital Length of Stay in High-risk Populations

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