The Impact of Different Nursing Skill Mix Models on Patient Outcomes in a Respiratory Care Center

Abstract

BackgroundMany hospitals have reformed hospital policies and changed nursing models to cope with shortages in nursing staff and control medical costs. However, the nursing skill mix model that most successfully achieves both cost effectiveness and quality care has yet to be determined.AimThe aim of this study was to explore the impact of different nurse staffing models on patient outcomes in a respiratory care center (RCC).MethodsRetrospective data from 2006 to 2008 were obtained from records monitoring nursing care quality, as well as patient records and nursing personnel costs in an RCC as a medical center, in southern Taiwan. A total of 487 patients were categorized into two groups according to the RCC's mix of nursing staff. The “RN/Aide” group comprised 247 patients who received RN and aide care, with a 0.7–0.8 proportion of RNs, from July 2006 to June 2007. The other 240 patients (“All-RN”) received 100% RN care from January 2008 to December 2008.ResultsThe results of this study indicated no significant differences in occurrence of pressure ulcer or respiratory tract infections, days of hospitalization, mortality, or nursing costs. However, significant differences were observed in ventilator weaning and occurrence of urinary tract and bloodstream infections.ConclusionsA higher proportion of RNs was associated not only with a lower rate of urinary tract infection but also with more patients being weaned successfully from ventilators. The findings of this study have implications for how managers and administrators manage nurse staffing in respiratory care.

The impact of three nursing staffing models on nursing outcomes

“…This finding is congruent that of Yang et al (2012), whose comparison of the effects of two different nursing skill mix models revealed that the patients in the group with 60-70% RNs had lower ventilator weaning rates than the patients in the 100% RN group. This finding is congruent that of Yang et al (2012), whose comparison of the effects of two different nursing skill mix models revealed that the patients in the group with 60-70% RNs had lower ventilator weaning rates than the patients in the 100% RN group.…”

“…The patients in the group with 100% RNs had a higher ventilator weaning rate than the group with 76% RNs. This finding is congruent that of Yang et al (2012), whose comparison of the effects of two different nursing skill mix models revealed that the patients in the group with 60-70% RNs had lower ventilator weaning rates than the patients in the 100% RN group. Previous studies have observed that patients experienced impaired communication, deficit of interaction, restlessness, loneliness and loss of control during mechanical ventilator weaning (Schou & Egerod 2008).…”

Estresse Ocupacional E Fatores Associados Entre Enfermeiros De Hospitais Públicos

“…Em consequência, têm-se complicações do quadro clínico do paciente, eventos adversos, aumento nas taxas de infecção, lesões por pressão, quedas, aumento do período de internação e dos custos, ou seja, prezuízos aos pacientes, às instituições de saúde e aos profissionais (13,24) . Embora haja avanços na compreensão de que o cuidado é interdisciplinar, a tomada de decisão sobre metas do cuidado com os pacientes e suas famílias é, histórica e culturalmente, atribuída ao médico.…”

Nursing care providers’ perceptions on their role contributions in patient care: An integrative review

“…Despite the established legal boundaries of professional nursing, nursing teams in both developing and developed countries usually now include unregulated healthcare providers, such as HCAs who may informally refer to themselves as nurses. In developed countries like Australia, UK, United States and Republic of China, this has resulted in the need to re‐examine the role of nursing care providers (Jacob et al., ; Yang, Hung, Chen, Hu, & Shieh, ; Goryakin, Griffiths, & Maben, ).…”

“…Worldwide, the HCA scope of practice varies and mainly depends on their place of work (Hewko et al., ). However, as unregulated healthcare providers, they work under the direction or supervision of a licensed nurse (RN or LPN) (College and Association of Registered Nurses of Alberta [CARNA], College of Licensed Practical Nurses of Alberta [CLPNA] & College of Registered Psychiatric Nurses of Alberta [CRPNA], ; Yang et al., ).…”