Value of Nurse Practitioner Inpatient Hospital Staffing

Datos Bibliográficos

ID9104664
AutoresLinda H Aiken (0000-0001-8004-3630, Center for Health Outcomes and Policy Research, The University of Pennsylvania School of Nursing, autor de correspondencia), Douglas M Sloane (0000-0003-2541-9783, Center for Health Outcomes and Policy Research, The University of Pennsylvania School of Nursing, autor de correspondencia), Heather Brom (0000-0002-4295-6372, Villanova University, autor de correspondencia), Heather M Brom (Center for Health Outcomes and Policy Research, The University of Pennsylvania School of Nursing), Barbara Todd (0000-0001-8306-2730, Hospital of the University of Pennsylvania, autor de correspondencia), Barbara A Todd (Center for Health Outcomes and Policy Research, The University of Pennsylvania School of Nursing), Hilary Barnes (0000-0002-6746-450X, Center for Health Outcomes and Policy Research, The University of Pennsylvania School of Nursing, autor de correspondencia), Jeannie P Cimiotti (0000-0003-0134-7797, Center for Health Outcomes and Policy Research, The University of Pennsylvania School of Nursing, autor de correspondencia), Regina S Cunningham (Center for Health Outcomes and Policy Research, The University of Pennsylvania School of Nursing, autor de correspondencia), Matthew D McHugh (0000-0002-1263-0697, Center for Health Outcomes and Policy Research, The University of Pennsylvania School of Nursing, autor de correspondencia)
Año2021
Volumen59
Número10
Páginas857-863
Fecha de publicación2021-10-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001628
PMID34432769
OpenAlexW3193776983
IdiomaEN
Citas recibidas3
Referencias citadas23

BACKGROUND: Evidence indicates hospitals with better registered nurse (RN) staffing have better patient outcomes. Whether involving more nurse practitioners (NPs) in inpatient care produces better outcomes is largely unknown. OBJECTIVE: The objective of this study was to determine whether the presence of more NPs produces better inpatient outcomes net of RN staffing. RESEARCH DESIGN: This was a 2015-2016 cross-sectional data on 579 hospitals linked from: (1) RN4CAST-US nurse surveys; (2) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient surveys; (3) surgical patient discharge abstracts; (4) Medicare Spending per Beneficiary (MSPB) reports; (5) American Hospital Association (AHA) Annual Survey. Hospitals were grouped according to their NP/beds ratios [<1 NP/100 beds (N=132), 1-2.99 NPs/100 beds (N=279), and 3+ NPs/100 beds (N=168)]. SUBJECTS: RNs randomly sampled nurses from licensure lists yielded 22,273 RNs in study hospitals; discharge data for 1.4 million surgical patients; HCAHPS data for 86% of study hospitals. MEASURES: Mortality, readmissions, lengths of stay, MSPB, patient experience, and quality reported by patients and nurses. RESULTS: After adjustments, patients in hospitals with 3+ NPs/100 beds had lower odds than patients in hospitals with <1 NP/100 beds of 30-day mortality [odds ratio (OR)2=0.76; 95% confidence interval (CI)=0.67-0.82; P<0.001] and 7-day readmissions (OR2=0.90; 95% CI=0.86-0.96; P<0.001), shorter average length of stay (incident rate ratio2=0.92; 95% CI=0.88-0.96; P<0.001) and 5.4% lower average MSPB (95% CI=3.8%-7.1%). Patients and nurses in the hospitals with higher NP/bed ratios were significantly more likely to report better care quality and safety, and nurses reported lower burnout, higher job satisfaction, greater intentions of staying in their jobs. CONCLUSIONS: Having more NPs in hospitals has favorable effects on patients, staff nurse satisfaction, and efficiency. NPs add value to existing labor resources

MEDLINE · Staffing · Statistics · Value (mathematics) · Medicine · Nursing · Nursing Diagnosis and Documentation · Nursing education and management · Nursing Roles and Practices