Nurse staffing and patient outcomes in inpatient rehabilitation settings.
In rehabilitation nursing, the patient classification systems or acuity models and nurse-staffing ratios are not supported by empirical evidence. Moreover there are no studies published characterizing nursing hours per patient day, proportion of RN staff and impact of agency nurses in inpatient rehabilitation settings. The purpose of this prospective observational study was to describe rehabilitation nurse staffing patterns, to validate the impact of rehabilitation nursing on patient outcomes, and to test whether existing patient measures on severity and outcomes in rehabilitation could be used as a proxy for burden of care to predict rehabilitation nurse staffing ceilings and daily nurse staffing requirements. A total of 54 rehabilitation facilities in the United States, stratified by geography, were randomly selected to participate in the study.
Nelson
Audrey
A
Patient Safety Center of Inquiry, James A Haley Veterans Administration Medical Center, Tampa, FL 33612, USA. audrey.nelson@va.gov
Powell-Cope
Gail
G
Palacios
Polly
P
Luther
Stephen L
SL
Black
Terrie
T
Hillman
Troy
T
Christiansen
Beth
B
Nathenson
Paul
P
Gross
Jan Coleman
JC
D000203:Activities of Daily Living; D002983:Clinical Competence; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016294:Models, Nursing; D020380:Needs Assessment / Q000458:organization & administration; D015401:Nursing Administration Research; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019984:Quality Indicators, Health Care; D019145:Rehabilitation Nursing / Q000193:education / Q000458:organization & administration*; D012720:Severity of Illness Index; D014481:United States; D016526:Workload / Q000706:statistics & numerical data*