The association between nursing factors and patient mortality in the Veterans Health Administration: the view from the nursing unit level

Medical Care
Anne SalesJack Needleman

Abstract

Nurse staffing is not the same across an entire hospital. Nursing care is delivered in geographically-based units, with wide variation in staffing levels. In particular, staffing in intensive care is much richer than in nonintensive care acute units. To evaluate the association of in-hospital patient mortality with registered nurse staffing and skill mix comparing hospital and unit level analysis using data from the Veterans Health Administration (VHA). A retrospective observational study using administrative data from 129,579 patients from 453 nursing units (171 ICU and 282 non-ICU) in 123 VHA hospitals. We used hierarchical multilevel regression models to adjust for patient, unit, and hospital characteristics, stratifying by whether or not patients had an ICU stay during admission. In-hospital mortality. : Of the 129,579 patients, mortality was 2.9% overall: 6.7% for patients with an ICU stay compared with 1.6% for those without. Whether the analysis was done at the hospital or unit level affected findings. RN staffing was not significantly associated with in-hospital mortality for patients with an ICU stay (OR, 1.02; 95% CI, 0.99-1.03). For non-ICU patients, increased RN staffing was significantly associated with decreased m...Continue Reading

References

Jun 1, 1992·Journal of Clinical Epidemiology·R A DeyoM A Ciol
Nov 1, 1994·Journal of Clinical Epidemiology·M CharlsonJ Gold
Jul 1, 1997·Health Affairs·N J Wilson, K W Kizer
Feb 7, 1998·Medical Care·A ElixhauserR M Coffey
Mar 21, 1998·Nursing Research·M A BlegenL Reed
Feb 24, 2001·The Journal of Nursing Administration·M A BlegenC J Goode
May 31, 2002·The New England Journal of Medicine·Jack NeedlemanKatya Zelevinsky
Sep 13, 2002·Health Affairs·Peter I BuerhausMaureen Stewart
Oct 22, 2002·JAMA : the Journal of the American Medical Association·Linda H AikenJeffrey H Silber
Jun 5, 2003·Annals of Internal Medicine·Andrew L RosenbergRodney A Hayward
Jun 10, 2003·Critical Care Medicine·Marta L RenderUNKNOWN VA ICU Project (VIP) Investigators
Sep 25, 2003·JAMA : the Journal of the American Medical Association·Linda H AikenJeffrey H Silber
Aug 11, 2004·The Journal of Nursing Administration·Thomas A LangRichard L Kravitz
Mar 22, 2005·Nursing Research·Carole A EstabrooksPhyllis Giovannetti
Oct 13, 2005·The Journal of Nursing Administration·Anne E SalesPaulette Cournoyer
Jan 13, 2006·Health Affairs·Jack NeedlemanSoeren Mattke
Apr 5, 2007·Medical Care Research and Review : MCRR·G Rumay Alexander

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Citations

Mar 18, 2011·The New England Journal of Medicine·Jack NeedlemanMarcelline Harris
Jan 14, 2011·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Marieke ZegersPeter P Groenewegen
Jun 15, 2011·Medical Care·Beatrice J KalischMonica Rochman
Oct 11, 2011·Computers, Informatics, Nursing : CIN·Anne E SalesYu-Fang Li
Jan 15, 2013·The Journal of Nursing Administration·Mary A BlegenJoanne Spetz
Apr 16, 2011·BMC Medical Research Methodology·Carole A EstabrooksPeter G Norton
Nov 27, 2009·Inquiry : a Journal of Medical Care Organization, Provision and Financing·Chuan-Fen LiuYu-Fang Li
Oct 4, 2014·The Journal of Nursing Administration·Gail Powell-CopeMichael Hodgson
Apr 12, 2014·Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing·Melanie C DreherArlene Sperhac
Oct 27, 2010·Applied Nursing Research : ANR·Christine DuffieldKate Aisbett
Oct 17, 2015·Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing·Chenjuan Ma, Shin Hye Park
Mar 7, 2013·Journal of Advanced Nursing·Christine L Covell, Souraya Sidani
Apr 11, 2012·Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing·Beverley Anne LansiquotElizabeth Madigan
Oct 10, 2013·Journal of Clinical Nursing·Sarah BurstonBrigid Gillespie
Nov 22, 2014·Journal of Advanced Nursing·Louise Winton SchreudersJudith Finn
Oct 15, 2013·Journal of Nursing Management·Ronda G HughesChrysmarie Suby
Oct 10, 2013·Health Services Research·Joanne Spetz, Timothy Bates
Jul 9, 2013·International Journal of Nursing Studies·Louise Winton SchreudersJudith Finn
Dec 12, 2012·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Daniel J MorganEli N Perencevich
Jul 6, 2016·Journal of Advanced Nursing·Ioannis GkantarasRichard Gray
Aug 15, 2014·Journal of Pain and Symptom Management·Ann Kutney-LeeMary Ersek
Feb 4, 2011·Policy, Politics & Nursing Practice·Jennifer B CarryerDenise Wilson
May 5, 2011·Western Journal of Nursing Research·Sara Breckenridge-SproatPatricia Patrician
Mar 3, 2018·International nursing review·Z R MahfoudR Gray
Mar 13, 2014·Journal of Korean Medical Science·Sang-Hyun KwakYounsuck Koh
Dec 8, 2010·Dimensions of Critical Care Nursing : DCCN·Valerie Eschiti, Patti Hamilton
Jul 16, 2011·Medical Care·Yu-Fang LiChuan-Fen Liu
Dec 12, 2012·Medical Care·Shin Hye ParkHolly A De Groot
Nov 28, 2013·Journal of the American Geriatrics Society·Cathleen S Colon-EmericRuth A Anderson
Dec 26, 2013·Critical Care Medicine·Deena M KellyLinda H Aiken
Dec 16, 2010·Nursing Administration Quarterly·E Faye AndersonBarbara Caspers
Jan 3, 2012·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Constantine A Manthous
Mar 18, 2010·Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses·Carol Legare, Jo-Ann V Sawatzky
Mar 20, 2015·BMJ Quality & Safety·Anne Sales
Sep 25, 2020·International Journal of Environmental Research and Public Health·Nompilo MoyoRichard Gray

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