Nurse Staffing and Patient Outcomes

Blegen, Mary A.; Goode, Colleen J.; Reed, Laura

doi:10.1097/00006199-199801000-00008

Cited by 388 publications

(268 citation statements)

References 15 publications

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“…Therefore the selection criteria were modified at this time to include these experience practitioners (Table 4.1). Canadian and American studies, 30% of a PICU"s nursing staff population should meet the criteria of experienced PIC nurse for the purpose of this survey (Blegen, Goode & Reed, 1998;Clark, 2002;Hall, Doran & Pink, 2004;Lang, Hodge, Olson, Romano & Kravitz, 2004;Lankshear, Sheldon & Maynard, 2005;Pilcher, Odell, Bray, Clarke, Gardner, Orr & Stirton, 2001;Spetz, 2001). As a conservative estimate, a total of 235 personnel for this study would have met the experienced nurse criteria from within the tertiary hospitals in Australia and New Zealand.…”

Section: Samplementioning

confidence: 98%

Determining standard criteria for endotracheal suctioning in the paediatric intensive care patient: An exploratory study

Davies

Monterosso

Leslie

2011

Intensive and Critical Care Nursing

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This four-phase mixed method study developed an evidence based ‘‘Endotracheal Suction Assessment Tool’’ (ESAT) as a guide for nurses undertaking ‘‘endotracheal tube’’ (ETT) suction within ‘‘Paediatric Intensive Care’’ (PIC). Phase 1 involved a comprehensive literature review to determine the most commonly used criteria for assessing the need for ETT suction. In Phase 2 an ‘‘Endotracheal Suction Questionnaire’’ (ESQ) was developed to survey experienced PIC nurses in Australia and New Zealand regarding their ETT suction decision making process and validity testing of the ESQ. In Phase 3, the ESQ was administered to target group (n = 104). In Phase 4, the empirical evidence generated from this study, based upon the criteria rated by nurses in this study as being most clinically important and essential during the decision making process, determined the ESAT design. Analyses of quantitative results showed a positive correlation between the perceived frequency of use of a criterion and the appropriateness of the assessment. Where a criterion was used less frequently as a clinical indicator for the requirement for ETT suction, participants had a lower regard for this when rating the criterion as a specific single indicator to perform suction. Findings from qualitative data identified six criteria not previously documented within the literature. Further testing and validation of the tool within the PIC setting will determine the clinical viability of the ESAT

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Section: Samplementioning

confidence: 98%

Determining standard criteria for endotracheal suctioning in the paediatric intensive care patient: An exploratory study

Davies

Monterosso

Leslie

2011

Intensive and Critical Care Nursing

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“…In addition, their pivotal role is given legal standing in Ireland's Health Act 2007, which compels a nursing home to have a nurse on the premises at all times. The literature suggests that nurses can affect patient outcomes, thus highlighting their contribution in the care delivery process (Aaronson et al, 1994;Blegen et al, 1998;Harrington et al, 2000). Nurses are supported in the care delivery process by health care attendants who undertake non-clinical duties.…”

Section: Labour Inputsmentioning

confidence: 99%

Technical and scale efficiency in public and private Irish nursing homes – a bootstrap DEA approach

Luasa

Dineen

Zieba

2016

Health Care Manag Sci

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This article provides methodological and empirical insights into the estimation of technical efficiency in the nursing home sector. Focusing on long-stay care and using primary data, we examine technical and scale efficiency in 39 public and 73 private Irish nursing homes by applying an input-oriented data envelopment analysis (DEA). We employ robust bootstrap methods to validate our nonparametric DEA scores and to integrate the effects of potential determinants in estimating the efficiencies. Both the homogenous and two-stage double bootstrap procedures are used to obtain confidence intervals for the bias-corrected DEA scores. Importantly, the application of the double bootstrap approach affords true DEA technical efficiency scores after adjusting for the effects of ownership, size, case-mix, and other determinants such as location, and quality. Based on our DEA results for variable returns to scale technology, the average technical efficiency score is 62%, and the mean scale efficiency is 88%, with nearly all units operating on the increasing returns to scale part of the production frontier. Moreover, based on the double bootstrap results, Irish nursing homes are less technically efficient, and more scale efficient than the conventional DEA estimates suggest. Regarding the efficiency determinants, in terms of ownership, we find that private facilities are less efficient than the public units. Furthermore, the size of the nursing home has a positive effect, and this reinforces our finding that Irish homes produce at increasing returns to scale. Also, notably, we find that a tendency towards quality improvements can lead to poorer technical efficiency performance.

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“…[8][9][10][11][12][13][14][15] These included urinary tract infections and pneumonia after major surgery, thrombosis and pulmonary compromise in surgical patients, 9 pneumonia in elective and emergency patients, 8 medication errors, pressure ulcers and patient complaints, 10,11 mortality rates 12 and nosocomial infection rates. 13 Other positive outcomes included better functional health outcomes, pain management and patients' perceptions of nursing care at discharge.…”

Section: The Relationship Between Nurse Staffing and Patient Outcomesmentioning

confidence: 99%

The impact of nurses on patient morbidity and mortality - the need for a policy change in response to the nursing shortage

Twigg

Duffield

Thompson

et al. 2010

Aust. Health Review

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Context. Workforce projections indicate that by 2012 there will be a shortfall of 61 000 registered nurses in Australia. There is a growing body of evidence that links registered nurse staffing to better patient outcomes.Purpose. This article provides a comprehensive review of the research linking nurse staf fing to patient outcomes at a time of growing shortages, highlighting that a policy response based on substituting registered nurses with lower skilled workers may have adverse effects on patient outcomes.Method. An electronic search of articles published in English using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Journals @ OVID and Medline was undertaken.Findings. Robust evidence exists nationally and internationally that links nurse staffing to patient outcomes. Recent meta-analyses have found that there was a 3-12% reduction in adverse outcomes and a 16% reduction in the risk of mortality in surgical patients with higher registered nurse staffing. Evidence confirms that improvements in nurse staffing is a cost-effective investment for the health system but this is not fully appreciated by health policy advisors.Conclusions. An appropriate policy response demands that the evidence that patient safety is linked to nurse staffing be recognised. Policy makers must ensure there are suf ficient registered nurses to guarantee patient safety.

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Nurse Staffing and Patient Outcomes

Abstract: The higher the RN skill mix, the lower the incidence of adverse occurrences on inpatient care units.

Cited by 388 publications

References 15 publications

Determining standard criteria for endotracheal suctioning in the paediatric intensive care patient: An exploratory study

Determining standard criteria for endotracheal suctioning in the paediatric intensive care patient: An exploratory study

Technical and scale efficiency in public and private Irish nursing homes – a bootstrap DEA approach

The impact of nurses on patient morbidity and mortality - the need for a policy change in response to the nursing shortage

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