Variations in nursing baccalaureate education and 30-day inpatient surgical mortality

Porat-Dahlerbruch, Joshua; Aiken, Linda H.; Lasater, Karen B.; Sloane, Douglas M.; McHugh, Matthew D

doi:10.1016/j.outlook.2021.09.009

Cited by 15 publications

(12 citation statements)

References 29 publications

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“…There was a correlation between nurse managers with a lower level of nursing education and uncertainty about working conditions. Previous studies have shown the importance of excellent leadership and a nurse's level of education [ 32 , 33 ]. It has been suggested that high-quality leadership may reduce nurses’ job stress and intentions of leaving the field.…”

Section: Discussionmentioning

confidence: 99%

“…Transformational and transactional leadership styles may reduce nurses’ job stress and intentions to leave the field, so nurse leaders can use a combination of transformational and transactional leadership to improve job satisfaction and the quality of nursing services. This means that nurse leaders can have an impact on improving job satisfaction, the quality of nursing and nurses’ education levels, which may impact patient mortality in surgical care [ 32 , 33 ]. However, it is also important that nurses also take responsibility for their own situations and create good relationships with management.…”

Section: Discussionmentioning

confidence: 99%

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Factors related to a successful professional development for specialist nurses in surgical care: a cross-sectional study

et al. 2023

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Background A high level of competence among staff is necessary for providing patient-safe surgical care. Knowledge regarding what factors contribute to the professional development of specialist nurses in surgical care and why they choose to remain in the workplace despite high work requirements is needed. To investigate and describe the organizational and social work environment of specialist nurses in surgical care as part of studying factors that impact on professional development. Method This was a cross-sectional study with a strategic convenience sampling procedure that recruited 73 specialist nurses in surgical care in Sweden between October to December 2021. The study was guided by STROBE Statement and checklist of cross-sectional studies. The validated Copenhagen Psychosocial Questionnaire was used, and additional demographic data. Descriptive statistics were performed and the comparison to the population benchmarks was presented as the mean with a 95% confidence interval. To study potential differences among the demographic and professional characteristics, pairwise t tests were used with Bonferroni adjustment for multiple comparisons with a significance level of 5%. Results Five domains were identified as factors related to success, as they received higher scores in relation to population benchmarks: quality of leadership, variation of work, meaning of work and work engagement as well as job insecurity. There was also a significant association between a having a manager with low nursing education and job insecurity (p = 0.021). Conclusions Quality of leadership is important for the professional development of specialist nurses in surgical care. Strategic work seems to include managers with a higher nursing education level to prevent insecure professional working conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors related to a successful professional development for specialist nurses in surgical care: a cross-sectional study

et al. 2023

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“…Nurses who were on sick leave, maternity leave, or on vacation were excluded. Slovenia faces a major shortage of RNs, with only 30% of RNs in the nursing workforce group, a far cry from the recommended 80% of nurses with a Bachelor of Science in Nursing degree (BSN) [ 29 , 30 ]. RNs are defined as those meeting the European Union definition of trained and licensed nurses according to Directive 2005/36/EC [ 31 ].…”

Section: Methodsmentioning

confidence: 99%

How nurses’ job characteristics affect their self-assessed work environment in hospitals— Slovenian use of the practice environment scale of the nursing work index

et al. 2023

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Background Nurses’ work environment influences nursing practice. Inappropriate working conditions are the result of underdeveloped workplace infrastructure, poor work organisation, inadequate education, and inappropriate staffing norms. The aim of this study was to describe and examine the predictors that affect nurses’ work environment using the Practice Environment Scale of the Nursing Work Index (PES-NWI). Methods The validation of the PES-NWI was made. Nurse-reported job characteristics were used as independent variables. The sample included 1,010 nurses from adult surgical and medical units at 10 Slovenian hospitals. The Nurse Forecasting (RN4CAST) protocol was used. Permission to conduct the study was obtained from the National Medical Ethics Committee. Results The PES-NWI mean (2.64) was low, as were job and career satisfaction at 2.96 and 2.89, respectively. The PES-NWI can be explained in 48% with ‘Opportunities for advancement’, ‘Educational opportunities’, ‘Satisfaction with current job’, ‘Professional status’, ‘Study leave’, and ‘Level of education’. A three-factor solution of PES-NWI yielded eight distinct variables. Conclusions The obtained average on the Nursing Work Index was one of the lowest among previously conducted surveys. Nurses should be recognized as equals in the healthcare workforce who need to be empowered to develop the profession and have career development opportunities. Inter-professional relations and equal involvement of nurses in hospital affairs are also very important. Trial registration This is a non-intervention study – retrospectively registered.

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“…Slovenia faces a major shortage of RNs, with only 30% of RNs in the nursing workforce group, a far cry from recommendations noted above -80% of nurses with a bachelor of science in nursing (BSN) (9,11). The title of nurse (RN) describes anyone meeting the European Union (EU) definition of a trained and licensed nurse according to Directive 2013/55/EU (16).…”

Section: Situation In Sloveniamentioning

confidence: 99%

“…The BSN educational pathway (four-year study programme) is recommended for at least 80% of the BSN workforce (8 -11). Higher hospital proportions of BSN nurses, regardless of educational pathway, are associated with lower odds of 30-day inpatient surgical mortality (5,9). Schlak et al (3) found that the work environment had a significant effect on patient outcomes, as a change in the work environment from poor to mixed or mixed to good was associated with a 14% drop in the odds of 30-day in-hospital mortality.…”

Section: Introductionmentioning

confidence: 99%

Patient Outcomes and Hospital Nurses’ Workload: A Cross-Sectional Observational Study in Slovenian Hospitals Using the RN4CAST Survey

Skela-Savič

Albreht

Sermeus

et al. 2023

Slovenian Journal of Public Health

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Introduction Higher nursing workload increases the odds of patient deaths, as the work environment has a significant effect on patient outcomes. The aim of the study was to explore the relation between patient outcomes and nurses’ working conditions in hospitals. Methods Administrative data on discharges of surgical patients for the year 2019 in eight general hospitals and two university medical centres in Slovenia were collected to determine in-hospital mortality within 30 days of admission. The RN4CAST survey questionnaire was used to gather data from nurses in these hospitals, with 1,010 nurses participating. Data was collected at the beginning of 2020. The number of nurses per shift and the nurse-to-patient ratio per shift were calculated. Univariate, bivariate and multivariate statistical methods were used to analyse the data. Results The 30-day in-hospital mortality for surgical patients was 1.00% in the hospitals sampled and ranged from 0.27% to 1.62%. The odds ratio for staffing suggests that each increase of one patient per RN is associated with a 6% increase in the likelihood of a patient dying within 30 days of admission. The mean patient-to-RN ratio was 15.56 (SD=2.50) and varied from 10.29 to 19.39. Four of the 13 tasks checked were not performed on patients during the last shift. Conclusion The results are not encouraging, with an extremely critical shortage of RNs and thus a high RN workload. The number of patients per RN is the highest in Europe and also higher than in some non-European countries, and represents an extreme risk to the quality of nursing and healthcare as a whole. The recommendation for acute non-emergency internal medicine and surgery departments is four patients per RN per shift.

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Variations in nursing baccalaureate education and 30-day inpatient surgical mortality

Cited by 15 publications

References 29 publications

Factors related to a successful professional development for specialist nurses in surgical care: a cross-sectional study

Factors related to a successful professional development for specialist nurses in surgical care: a cross-sectional study

How nurses’ job characteristics affect their self-assessed work environment in hospitals— Slovenian use of the practice environment scale of the nursing work index

Patient Outcomes and Hospital Nurses’ Workload: A Cross-Sectional Observational Study in Slovenian Hospitals Using the RN4CAST Survey

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