Nurse staffing and skill mix patterns: Are there differences in outcomes?

Abstract

The purpose of this study was to examine the impact on patient outcomes of nurse staffing and registered nurse (RN) skill mix patterns used by medical-surgical units in California hospitals after enactment of nurse-to-patient staffing ratio laws, and determine if there are differences in patient outcomes for conditions that are considered sensitive to nursing care. Results from this study demonstrated an association between total nursing hours per patient day (NHPPD) and two outcomes: urinary tract infections (UTI) and length of stay (LOS). A stronger association was observed between the RN proportions of the total nursing hours of care and the same outcomes. The higher the total NHPPD and RN proportion, the lower the LOS and the lower the odds of hospitalized patients' developing UTI.

The impact of three nursing staffing models on nursing outcomes

“…The patients in the groups with 76% RNs and 92% RNs had a higher rate of urinary tract infections than the group with 100% RNs, a finding similar to those of previous studies (Aiken et al 2002, Needleman et al 2002, Horn et al 2005, Esparza et al 2012. In this study, the RCC nurse aides who were dispatched by a care centre had to care for more patients with catheters than those in general wards.…”

A quantitative systematic review of the association between nurse skill mix and nursing‐sensitive patient outcomes in the acute care setting

“…Barkell et al (2002),Blegen et al (2011,Martsolf et al (2014),Twigg et al (2012),Yang et al (2015) 6 deCordova et al (2014),Esparza et al (2012),Frith et al (2010),Kim, Park, et al (2016),McCloskey and Diers (2005), Needleman et al (2002), Pitkäaho et al . (2011), Goode et al (2011), Needleman et al (2002), Park et al (2012), Roche et al (2012), Seago et al (2006), Twigg et al (2016), Twigg et al (2012), Unruh and Zang (2012.…”

The changing boundaries of nursing: a qualitative study of the transition to a new nursing care delivery model

“…How do we reconcile these two perspectives? An increasing number of studies show that a higher ratio of RNs leads to better patient outcomes (Rafferty et al 2007, Esparza et al 2012, Aiken et al 2014. However, caution must be used in interpreting study results given the complex relationship between staffing and outcomes as well as intervening variables which can influ-ence patient outcomes (Clarke 2006).…”