Nurse Staffing

The Effects of Nurse
Staffing on Patient Safety

Evidence and Methodology
• Our goal is clearly defined---- To assess whether nurse staffing effects patient safety in the form of inpatient hospital mortality and patient safety • Our studies are observational and taken from random samples adjusted for risk and hospital characteristics----Data was obtained from nurse surveys and risk-adjusted 30-day inpatient mortality and failure to rescue. Pt discharge data was obtained from the state agencies. Evidence and
Methodology

• Our articles are peer reviewed

• Our articles have credentialed authors related to the research subject • Our articles have few assumptions and uses statistics and risk adjustments to rule out variables and bias’s
• Ethical
Cronbach’s alpha statistics was used to account for variables and test the interal reliability of study results
3. Descriptive statistics were used to assess extreme or outliers
4. Elixhauser’s and Carlson index was used for clinical prognosis and comorbidity adjustments
5. C-statistic risk-adjustment was used for hospital quality, characteristics, and performance
6. Practice Environment Scale of the Nursing Work Index(PES-NWI) was used as a control variable that gauge’s the quality of the nursing practice environment
7. In order to account for clustering of patients common with randomized observational studies, the Huber-White estimates were used.

Appraisal
The first two studies compared nurse staffing levels to patient outcomes.
The third study looked at nurses’ subjective assessment based on their staffing levels and resource adequacy
Validity of the first two studies are good because they were based on direct measurements of mortality. The third study seemed to have less validity as it was based on nurses opinion of patient safety.

Apprais al • Ethical approval was given prior to research.
• Relevance is important because nursing is one of the largest categories in the hospital and makes up 25% of annual operating expenses and
References
Aiken, L. H., Cimiotti, J. P., Sloane, D. M., Smith, H. L., Flynn, L., & Neff, D. F. (2011, Dec). The Effects of Nurse Staffing and Nurse Education on Patient Deaths in Hospital with different Nurse Work Envirnments. Med Care, 49(12), 10471053. http://dx.doi.org/10.1097/MLR.ObO13e318233Ob6e
Aiken, L. H., Sloane, D. M., & Bruyneel, L. (2014, May 24th). Nurse Staffing and Education and hospital Mortality in Nine
European Countries: A Retrospective Observational Study. The Lancet, 383(9931). http://dx.doi.org/10.1016/S01406736(13)62631-8
Alenius, L. S., Tishelman, C., Runesdotter, S., & Lindqvist, R. (2013, Oct 14th). Staffing and resource adequacy strongly related to RNs assessment of patient safety: a national study of RNs working in acute care hospitals in Sweden. BMJ
Quality Safety, 23, 242-249. http://dx.doi.org/10.1136/bmjqs-2012-001734
Needleman, J., Buerhaus, P., Pankratz, V. S., Leibson, C. L., Stevens, S. R., & Harris, M. (2011, March 17). Nurse Staffing and Inpatient Hospital Mortality. New England Journal of Medicine, 364, 1037-1045.