The relationship between nurse staffing and inpatient complications
Aim To compare characteristics of hospitalizations with and without complications and examine the impact of nurse staffing on inpatient complications across different unit types. Background Studies investigating the relationship between nurse staffing and inpatient complications have not shown consi...
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| Veröffentlicht in: | Journal of advanced nursing 2015-04, Vol.71 (4), p.800-812 |
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| creator | Schreuders, Louise Winton Bremner, Alexandra P. Geelhoed, Elizabeth Finn, Judith |
| description | Aim
To compare characteristics of hospitalizations with and without complications and examine the impact of nurse staffing on inpatient complications across different unit types.
Background
Studies investigating the relationship between nurse staffing and inpatient complications have not shown consistent results. Methodological limitations have been cited as the basis for this lack of uniformity. Our study was designed to address some of these limitations.
Design
Retrospective longitudinal hospitalization‐level study.
Method
Adult hospitalizations to high intensity, general medical and general surgical units at three metropolitan tertiary hospitals were included. Data were sourced from Western Australian Department of Health administrative data collections from 2004–2008.
We estimated the impact of nurse staffing on inpatient complications adjusted for patient and hospital characteristics and accounted for patients with multiple hospitalizations.
Results
The study included 256,984 hospitalizations across 58 inpatient units. Hospitalizations with complications had significantly different demographic characteristics compared with those without. The direction of the association between nurse staffing and inpatient complications was not consistent for different inpatient complications, nurse skill mix groups or for hospitalizations with different unit movement patterns.
Conclusion
Our study design addressed limitations noted in the field, but our results did not support the widely held assumption that improved nurse staffing levels are associated with decreased patient complication rates. Despite a strong international focus on improving nurse staffing to reduce inpatient complications, our results suggest that adding more nurses is not a panacea for reducing inpatient complications to zero. |
| doi_str_mv | 10.1111/jan.12572 |
| format | Article |
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To compare characteristics of hospitalizations with and without complications and examine the impact of nurse staffing on inpatient complications across different unit types.
Background
Studies investigating the relationship between nurse staffing and inpatient complications have not shown consistent results. Methodological limitations have been cited as the basis for this lack of uniformity. Our study was designed to address some of these limitations.
Design
Retrospective longitudinal hospitalization‐level study.
Method
Adult hospitalizations to high intensity, general medical and general surgical units at three metropolitan tertiary hospitals were included. Data were sourced from Western Australian Department of Health administrative data collections from 2004–2008.
We estimated the impact of nurse staffing on inpatient complications adjusted for patient and hospital characteristics and accounted for patients with multiple hospitalizations.
Results
The study included 256,984 hospitalizations across 58 inpatient units. Hospitalizations with complications had significantly different demographic characteristics compared with those without. The direction of the association between nurse staffing and inpatient complications was not consistent for different inpatient complications, nurse skill mix groups or for hospitalizations with different unit movement patterns.
Conclusion
Our study design addressed limitations noted in the field, but our results did not support the widely held assumption that improved nurse staffing levels are associated with decreased patient complication rates. Despite a strong international focus on improving nurse staffing to reduce inpatient complications, our results suggest that adding more nurses is not a panacea for reducing inpatient complications to zero.</description><identifier>ISSN: 0309-2402</identifier><identifier>EISSN: 1365-2648</identifier><identifier>DOI: 10.1111/jan.12572</identifier><identifier>PMID: 25414059</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject><![CDATA[Adolescent ; Adult ; adult nursing ; Aged ; Aged, 80 and over ; Clinical Nursing Research ; Female ; Hospitalization ; Hospitalization - statistics & numerical data ; Humans ; Longitudinal Studies ; Male ; medical record linkage ; Middle Aged ; Nurse patient relationships ; Nurses ; Nursing ; Nursing care ; nursing methodology research ; Nursing Staff, Hospital - organization & administration ; outcome assessment ; Outcome Assessment (Health Care) - statistics & numerical data ; Patient Readmission - statistics & numerical data ; Personnel Staffing and Scheduling - organization & administration ; quality indicators ; Quality Indicators, Health Care - statistics & numerical data ; Quality of care ; Retrospective Studies ; Western Australia ; Workforce planning ; Young Adult]]></subject><ispartof>Journal of advanced nursing, 2015-04, Vol.71 (4), p.800-812</ispartof><rights>2014 John Wiley & Sons Ltd</rights><rights>2014 John Wiley & Sons Ltd.</rights><rights>Copyright Wiley Subscription Services, Inc. Apr 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4592-af9bc803ba63af931d5032fe6d356dda7a94c7757504ffb12e45f7b8061894c3</citedby><cites>FETCH-LOGICAL-c4592-af9bc803ba63af931d5032fe6d356dda7a94c7757504ffb12e45f7b8061894c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjan.12572$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjan.12572$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,30998,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25414059$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schreuders, Louise Winton</creatorcontrib><creatorcontrib>Bremner, Alexandra P.</creatorcontrib><creatorcontrib>Geelhoed, Elizabeth</creatorcontrib><creatorcontrib>Finn, Judith</creatorcontrib><title>The relationship between nurse staffing and inpatient complications</title><title>Journal of advanced nursing</title><addtitle>J Adv Nurs</addtitle><description>Aim
To compare characteristics of hospitalizations with and without complications and examine the impact of nurse staffing on inpatient complications across different unit types.
Background
Studies investigating the relationship between nurse staffing and inpatient complications have not shown consistent results. Methodological limitations have been cited as the basis for this lack of uniformity. Our study was designed to address some of these limitations.
Design
Retrospective longitudinal hospitalization‐level study.
Method
Adult hospitalizations to high intensity, general medical and general surgical units at three metropolitan tertiary hospitals were included. Data were sourced from Western Australian Department of Health administrative data collections from 2004–2008.
We estimated the impact of nurse staffing on inpatient complications adjusted for patient and hospital characteristics and accounted for patients with multiple hospitalizations.
Results
The study included 256,984 hospitalizations across 58 inpatient units. Hospitalizations with complications had significantly different demographic characteristics compared with those without. The direction of the association between nurse staffing and inpatient complications was not consistent for different inpatient complications, nurse skill mix groups or for hospitalizations with different unit movement patterns.
Conclusion
Our study design addressed limitations noted in the field, but our results did not support the widely held assumption that improved nurse staffing levels are associated with decreased patient complication rates. Despite a strong international focus on improving nurse staffing to reduce inpatient complications, our results suggest that adding more nurses is not a panacea for reducing inpatient complications to zero.</description><subject>Adolescent</subject><subject>Adult</subject><subject>adult nursing</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Clinical Nursing Research</subject><subject>Female</subject><subject>Hospitalization</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>medical record linkage</subject><subject>Middle Aged</subject><subject>Nurse patient relationships</subject><subject>Nurses</subject><subject>Nursing</subject><subject>Nursing care</subject><subject>nursing methodology research</subject><subject>Nursing Staff, Hospital - organization & administration</subject><subject>outcome assessment</subject><subject>Outcome Assessment (Health Care) - statistics & numerical data</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Personnel Staffing and Scheduling - organization & administration</subject><subject>quality indicators</subject><subject>Quality Indicators, Health Care - statistics & numerical data</subject><subject>Quality of care</subject><subject>Retrospective Studies</subject><subject>Western Australia</subject><subject>Workforce planning</subject><subject>Young Adult</subject><issn>0309-2402</issn><issn>1365-2648</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqN0U9L5DAYBvAgKzqrHvwCUtiLe6jmf9qjDOoqoiADegtp-0YzdtKatKjffqNVD4JgLgnk9z6QPAjtEnxA0jpcGn9AqFB0Dc0IkyKnkhe_0AwzXOaUY7qJfse4xJgwSukG2qSCE45FOUPzxT1kAVozuM7He9dnFQxPAD7zY4iQxcFY6_xdZnyTOd8nB37I6m7Vt66eprbRujVthJ33fQstTo4X83_5xdXp2fzoIq-5KGlubFnVBWaVkSydGWkEZtSCbJiQTWOUKXmtlFACc2srQoELq6oCS1KkG7aF9qfYPnSPI8RBr1ysoW2Nh26MmkhFcSklKX9AJS5pwYVK9M8XuuzG4NM7XhVjKZLipP5Oqg5djAGs7oNbmfCiCdavHejUgX7rINm998SxWkHzKT8-PYHDCTy5Fl6-T9LnR5cfkfk04eIAz58TJjxoqZgS-ubyVM_Jye3Ngl_ra_YfowyeDA</recordid><startdate>201504</startdate><enddate>201504</enddate><creator>Schreuders, Louise Winton</creator><creator>Bremner, Alexandra P.</creator><creator>Geelhoed, Elizabeth</creator><creator>Finn, Judith</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201504</creationdate><title>The relationship between nurse staffing and inpatient complications</title><author>Schreuders, Louise Winton ; Bremner, Alexandra P. ; Geelhoed, Elizabeth ; Finn, Judith</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4592-af9bc803ba63af931d5032fe6d356dda7a94c7757504ffb12e45f7b8061894c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>adult nursing</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Clinical Nursing Research</topic><topic>Female</topic><topic>Hospitalization</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>medical record linkage</topic><topic>Middle Aged</topic><topic>Nurse patient relationships</topic><topic>Nurses</topic><topic>Nursing</topic><topic>Nursing care</topic><topic>nursing methodology research</topic><topic>Nursing Staff, Hospital - organization & administration</topic><topic>outcome assessment</topic><topic>Outcome Assessment (Health Care) - statistics & numerical data</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Personnel Staffing and Scheduling - organization & administration</topic><topic>quality indicators</topic><topic>Quality Indicators, Health Care - statistics & numerical data</topic><topic>Quality of care</topic><topic>Retrospective Studies</topic><topic>Western Australia</topic><topic>Workforce planning</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schreuders, Louise Winton</creatorcontrib><creatorcontrib>Bremner, Alexandra P.</creatorcontrib><creatorcontrib>Geelhoed, Elizabeth</creatorcontrib><creatorcontrib>Finn, Judith</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of advanced nursing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schreuders, Louise Winton</au><au>Bremner, Alexandra P.</au><au>Geelhoed, Elizabeth</au><au>Finn, Judith</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The relationship between nurse staffing and inpatient complications</atitle><jtitle>Journal of advanced nursing</jtitle><addtitle>J Adv Nurs</addtitle><date>2015-04</date><risdate>2015</risdate><volume>71</volume><issue>4</issue><spage>800</spage><epage>812</epage><pages>800-812</pages><issn>0309-2402</issn><eissn>1365-2648</eissn><abstract>Aim
To compare characteristics of hospitalizations with and without complications and examine the impact of nurse staffing on inpatient complications across different unit types.
Background
Studies investigating the relationship between nurse staffing and inpatient complications have not shown consistent results. Methodological limitations have been cited as the basis for this lack of uniformity. Our study was designed to address some of these limitations.
Design
Retrospective longitudinal hospitalization‐level study.
Method
Adult hospitalizations to high intensity, general medical and general surgical units at three metropolitan tertiary hospitals were included. Data were sourced from Western Australian Department of Health administrative data collections from 2004–2008.
We estimated the impact of nurse staffing on inpatient complications adjusted for patient and hospital characteristics and accounted for patients with multiple hospitalizations.
Results
The study included 256,984 hospitalizations across 58 inpatient units. Hospitalizations with complications had significantly different demographic characteristics compared with those without. The direction of the association between nurse staffing and inpatient complications was not consistent for different inpatient complications, nurse skill mix groups or for hospitalizations with different unit movement patterns.
Conclusion
Our study design addressed limitations noted in the field, but our results did not support the widely held assumption that improved nurse staffing levels are associated with decreased patient complication rates. Despite a strong international focus on improving nurse staffing to reduce inpatient complications, our results suggest that adding more nurses is not a panacea for reducing inpatient complications to zero.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>25414059</pmid><doi>10.1111/jan.12572</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of advanced nursing, 2015-04, Vol.71 (4), p.800-812 |
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| source | MEDLINE; Applied Social Sciences Index & Abstracts (ASSIA); Wiley Online Library All Journals |
| subjects | Adolescent Adult adult nursing Aged Aged, 80 and over Clinical Nursing Research Female Hospitalization Hospitalization - statistics & numerical data Humans Longitudinal Studies Male medical record linkage Middle Aged Nurse patient relationships Nurses Nursing Nursing care nursing methodology research Nursing Staff, Hospital - organization & administration outcome assessment Outcome Assessment (Health Care) - statistics & numerical data Patient Readmission - statistics & numerical data Personnel Staffing and Scheduling - organization & administration quality indicators Quality Indicators, Health Care - statistics & numerical data Quality of care Retrospective Studies Western Australia Workforce planning Young Adult |
| title | The relationship between nurse staffing and inpatient complications |
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