Nurse staffing models as predictors of patient outcomes.
BACKGROUND
Little research has been conducted that examined the intended effects of nursing care on clinical outcomes.


OBJECTIVE
The objective of this study was to evaluate the impact of different nurse staffing models on the patient outcomes of functional status, pain control, and patient satisfaction with nursing care.


METHODS
A repeated-measures study was conducted in all 19 teaching hospitals in Ontario, Canada.


METHODS
The sample comprised hospitals and adult medical-surgical and obstetric inpatients within those hospitals.


METHODS
The patient's functional health outcomes were assessed with the Functional Independence Measure (FIM) and the Medical Outcome Study SF-36. Pain was assessed with the Brief Pain Inventory and patient perceptions of nursing care were measured with the nursing care quality subscale of the Patient Judgment of Hospital Quality Questionnaire.


RESULTS
The proportion of regulated nursing staff on the unit was associated with better FIM scores and better social function scores at hospital discharge. In addition, a mix of staff that included RNs and unregulated workers was associated with better pain outcomes at discharge than a mix that involved RNs/RPNs and unregulated workers. Finally, patients were more satisfied with their obstetric nursing care on units where there was a higher proportion of regulated staff.


CONCLUSIONS
The results of this study suggest that a higher proportion of RNs/RPNs on inpatient units in Ontario teaching hospitals is associated with better clinical outcomes at the time of hospital discharge.
McGillis Hall
Linda
L
Nursing Effectiveness, Utilization, and Outcomes Research Unit, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada. l.mcgillishall@utoronto.ca
Doran
Diane
D
Baker
G Ross
GR
Pink
George H
GH
Sidani
Souraya
S
O'Brien-Pallas
Linda
L
Donner
Gail J
GJ
D000328:Adult; D005260:Female; D006305:Health Status Indicators; D006784:Hospitals, Teaching / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D009741:Nursing Staff, Hospital / Q000600:supply & distribution*; D009773:Obstetric Nursing / Q000458:organization & administration*; D009864:Ontario; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D017060:Patient Satisfaction; D013527:Perioperative Nursing / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D011247:Pregnancy; D013997:Time Factors; D000078329:Workforce