Registered nurse unions and patient outcomes.
Although research shows substantial relationships between several organizational characteristics in hospitals and patient outcomes, the relationship between nurse unions and patient outcomes has not been explored. Because of the workplace chaos of the last half of the 1990s, some nurses are rethinking their relationships with unions; some have the perception that union activity has increased. It is not always clear whether changes in healthcare are associated with patient outcomes, but it is clear that hospitals/health systems with unions often engage in spirited rhetoric about what is best for patients with little objective evidence to support either view. This study examines the relationship between the presence of a bargaining unit for registered nurses and the acute myocardial infarction mortality rate for acute care hospitals in California. The authors also discuss how registered nurse wage, hospital bed size, volume of patients, and other organizational factors may influence and confound this relationship.
Seago
Jean Ann
JA
Department of Community Health Systems, Center for the Health Professions, University of California, Box 0608, San Francisco, CA 94143-0608, USA. jean.ann.seago@nursing.ucsf.edu
Ash
Michael
M
D000208:Acute Disease; D002140:California / Q000453:epidemiology; D002908:Chronic Disease; D015897:Comorbidity; D015987:Effect Modifier, Epidemiologic; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006801:Humans; D007750:Labor Unions / Q000592:standards*; D016014:Linear Models; D009203:Myocardial Infarction / Q000401:mortality* / Q000451:nursing*; D015401:Nursing Administration Research; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000592:standards* / Q000600:supply & distribution; D017063:Outcome Assessment, Health Care; D010561:Personnel Staffing and Scheduling / Q000592:standards; D011237:Predictive Value of Tests; D012307:Risk Factors; D012456:Salaries and Fringe Benefits / Q000706:statistics & numerical data