Will Mandated Minimum Nurse Staffing Ratios Lead to Better Patient Outcomes
Bibliographic Data
| ID | 9100189 |
|---|---|
| Authors | Julie Sochalski (University of Pennsylvania, corresponding author), R Tamara Konetzka (0000-0003-3016-1318, University of Chicago), Jingsan Zhu (University of Pennsylvania), Kevin G Volpp (0000-0003-3389-6707, University of Pennsylvania), Kevin Volpp |
| Year | 2008 |
| Volume | 46 |
| Issue | 6 |
| Pages | 606-613 |
| Publication date | 2008-06-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0b013e3181648e5c |
| PMID | 18520315 |
| OpenAlex | W2005984555 |
| Language | EN |
| Citations received | 3 |
| References cited | 31 |
BACKGROUND: Mandatory hospital nurse staffing ratios are under consideration in a number of states without strong empirical evidence of the optimal ratio. OBJECTIVE: To determine whether increases in medical-surgical licensed nurse staffing levels are associated with improvements in patient outcomes for hospitals having different baseline staffing levels. RESEARCH DESIGN: Cross-sectional and fixed-effects regression analyses using a 1993-2001 panel of patient and hospital data from California. Splines define 4 staffing ratios. SUBJECTS: Adult acute myocardial infarction (AMI) (n = 348,720) and surgical failure to rescue (FTR) (n = 109,066) patients discharged between 1993 and 2001 from 343 California acute care general hospitals. MEASURES: Patient outcomes are 30-day AMI mortality and surgical FTR; 4 baseline staffing levels-4 to 7 patients per licensed nurse [registered nurses (RN) and licensed vocational nurses (LVN)]. RESULTS: Significant cross-sectional associations between higher nurse staffing and AMI mortality are reduced in the fixed-effects analyses. Improvements in outcomes were smaller in hospitals with higher baseline staffing: for each RN and RN + LVN increase, respectively, AMI mortality declined by 0.71 (P < 0.05) and by 2.75 percentage points for hospitals with more than 7 patients per nurse compared with 0.19 (P = NS) and 0.28 percentage points (P < 0.05) in hospitals with more than 4 patients per nurse. Significant cross-sectional associations between higher nurse staffing and FTR were not found in the fixed-effects analyses. CONCLUSIONS: Strong diminishing returns to nurse staffing improvements and lack of significant evidence that staffing uniformly increases improve outcomes raise questions about the likely cost-effectiveness of implementing state-wide mandatory nurse staffing ratios
Cross-sectional study · Staffing · Emergency Medicine · Geriatric Care and Nursing Homes · Medicine · Nursing · Nursing education and management · Nursing Roles and Practices
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Nurse Staffing and Mortality for Medicare Patients with Acute Myocardial Infarction
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Licensed Nurse Staffing and Adverse Events in Hospitals
| Citations per year | 0.19 |
|---|---|
| Citation span | 2010 - 2020 (11) |
| Highly cited | No |