Nurse Staffing and Inpatient Hospital Mortality
New England Journal of MedicinePublished 16 March 2011Open access
Jack Needleman, Peter I. Buerhaus, V. Shane Pankratz, Cynthia L. Leibson, Susanna R. Stevens, Marcelline R. Harris
Citations897
SJR quartileQ1
SJR score19.08
SNIP13.47
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Staffing of RNs below target levels was associated with increased mortality, which reinforces the need to match staffing with patients' needs for nursing care.
Abstract
In this retrospective observational study, staffing of RNs below target levels was associated with increased mortality, which reinforces the need to match staffing with patients' needs for nursing care. (Funded by the Agency for Healthcare Research and Quality.).
Keywords
Health ProfessionsEconomics, Econometrics and Finance
Medical CareComorbidity Measures for Use with Administrative Data
9,920 Citations1998Anne Elixhauser, Claudia Steiner +2 more
The present method addresses some of the limitations of previous measures and produces an expanded set of comorbidities that easily is applied without further refinement to administrative data for a wide range of diseases.
JAMAHospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction
5,188 Citations2002Linda H. Aiken
In hospitals with high patient-to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates, and nurses are more likely to experience burnout and job dissatisfaction.
New England Journal of MedicineNurse-Staffing Levels and the Quality of Care in Hospitals
2,260 Citations2002Jack Needleman, Peter I. Buerhaus +3 more
Medical CareThe Association of Registered Nurse Staffing Levels and Patient Outcomes
1,078 Citations2007Robert L Kane, Tatyana Shamliyan +3 more
Increased RN staffing was associated with lower hospital related mortality in intensive care units (ICUs) and lower odds of hospitalrelated mortality and adverse patient events and patient and hospital characteristics, including hospitals’ commitment to quality of medical care, likely contribute to the actual causal pathway.
New England Journal of MedicinePatients' Perception of Hospital Care in the United States
874 Citations2008Ashish K. Jha, E. John Orav +2 more
This portrait of patients' experiences in U.S. hospitals offers insights into areas that need improvement, suggests that the same characteristics of hospitals that lead to high nurse-staffing levels may be associated with better experiences for patients, and offers evidence that hospitals can provide both a high quality of clinical care and a good experience for the patient.
Nursing ResearchThe Effects of Nurse Staffing on Adverse Events, Morbidity, Mortality, and Medical Costs
490 Citations2003Sung-Hyun Cho, S Ketefian +2 more
Patients are experiencing adverse events during hospitalization that are associated with a significantly prolonged length of stay and increased medical costs, and care systems to reduce adverse events and their consequences are needed.
Nursing ResearchNurse Staffing and Patient Outcomes
489 Citations1998Mary A. Blegen, Colleen J. Goode +1 more
The higher the RN skill mix, the lower the incidence of adverse occurrences on inpatient care units, and the relationship between RN proportion of care and adverse outcomes was curvilinear.
JONA The Journal of Nursing AdministrationNurse???Patient Ratios
424 Citations2004T. Lang, Margaret Hodge +3 more
The literature offers no support for specific, minimum nurse–patient ratios for acute care hospitals, especially in the absence of adjustments for skill and patient mix, although total nursing hours and skill mix do appear to affect some important patient outcomes.
Image the Journal of Nursing ScholarshipNurse Staffing Levels and Adverse Events Following Surgery in U.S. Hospitals
404 Citations1998Christine Kovner, Peter J. Gergen
Inverse relationships between nurse staffing and these adverse events provide information for managers to use when redesigning and restructuring the clinical workforce employed in providing inpatient care.
Health AffairsNurse Staffing In Hospitals: Is There A Business Case For Quality?
305 Citations2006Jack Needleman, Peter I. Buerhaus +3 more
Medical CareLicensed Nurse Staffing and Adverse Events in Hospitals
235 Citations2003Lynn Unruh
This study suggests that licensed nurses’ patient load began increasing in the 1990s, and adequate licensed nurse staffing is important in minimizing the incidence of adverse events in hospitals.
Health Services ResearchA Longitudinal Examination of Hospital Registered Nurse Staffing and Quality of Care
232 Citations2004Barbara A. Mark, David W. Harless +2 more
Limited support is provided for the prevailing notion that improving registered nurse (RN) staffing unconditionally improves quality of care by examining the effects of change in registered nurse staffing on change inquality of care.
Health Services ResearchNurse Staffing and Postsurgical Adverse Events: An Analysis of Administrative Data from a Sample of U.S. Hospitals, 1990–1996
231 Citations2002Christine Kovner, Jones Cheryl +3 more
An inverse relationship was found between RN hours per adjusted inpatient day and pneumonia (p < .05) for routine and emergency patient admissions and the results provide additional evidence for health policy makers to consider when making decisions about required staffing levels to minimize adverse events.
PubMedA multisite study of nurse staffing and patient occurrences.
218 Citations1999M. Blegen, Thomas Vaughn
This study determined the relationship between different levels of nurse staffing and patient outcomes (adverse occurrences) and found the "non-linear" relationship between the proportion of RNs in the staff mix and MAEs.
Medical CareThe Economic Value of Professional Nursing
181 Citations2008Timothy M. Dall, Yaozhu J. Chen +3 more
Heart & LungPostoperative complications: Does intensive care unit staff nursing make a difference?
122 Citations2002Deborah Dang, Mary E. Johantgen +3 more
Within the range of ICU nurse staffing levels present in Maryland hospitals, decreased nurse staffing was significantly associated with an increased risk of complications in patients undergoing abdominal aortic surgery.
Archives of Internal MedicineQuality of Care for the Treatment of Acute Medical Conditions in US Hospitals
116 Citations2006Bruce E. Landon
Patients are more likely to receive high-quality care in not-for-profit hospitals and in hospitals with high registered nurse staffing ratios and more investment in technology, which indicates the effect of alternative payment approaches on quality.
Medical CareThe Association Between Nursing Factors and Patient Mortality in the Veterans Health Administration
102 Citations2008Anne Sales, NANCY SHARP +12 more
The findings suggest that the association between RN staffing and skill mix and in-hospital patient mortality depends on whether the analysis is conducted at the hospital or unit level.
New England Journal of MedicineBuilding a Bridge from Fragmentation to Accountability — The Prometheus Payment Model
97 Citations2009François de Brantes, Meredith B. Rosenthal +1 more
The Prometheus Payment model is described, which proposes a payment system that could promote and sustain high-value care and motivate the development of accountable care organizations.
Western Journal of Nursing ResearchMethodological Issues in Nurse Staffing Research
96 Citations2006Barbara A. Mark
Health Services ResearchPatient Turnover and Nursing Staff Adequacy
84 Citations2006Lynn Unruh, Myron D. Fottler
Assessment of unadjusted RN staffing by RN to patient ratios alone underestimates nursing workload and overstates RN staffing levels, indicating patient turnover, as well as severity, should be taken into account in staffing assessment and decision making.
Journal of Health EconomicsPatient outcomes when hospitals experience a surge in admissions
68 Citations2005William N. Evans, Beom‐Soo Kim
Estimating the impact of hospital staff levels on adverse events by examining whether outcomes are correlated with the number of admissions in the hospital over the next 2 days suggests that the portion of the California law designed to guarantee adequate staffing when the patient census increases unexpectedly should have little impact on patient outcomes.
Evidence-Based NursingThe style of nursing leadership in hospitals is an independent risk factor for 30-day mortality of patients in acute care
3 Citations2011Lisbeth Fagerström
