Evaluation of a patient care delivery model: patient outcomes in acute cardiac care.
OBJECTIVE
To evaluate the influence of nurse staffing and work environment variables on patient outcomes by testing a conceptual model.


METHODS
A prospective, correlational design with cross-sectional and longitudinal components was conducted in Canadian cardiac and cardiovascular care inpatient units.


METHODS
Data were collected from multiple sources. Hierarchical linear modeling was used to examine relationships among variables.


CONCLUSIONS
The findings indicate that patient outcomes are influenced not only by patient and nurse characteristics, but also by organizational staffing practices. Organizations that manage the complexity of work conditions and target staffing utilization levels between 80% and 88% at the unit level can optimize patient outcomes.


CONCLUSIONS
Empirical validation of the model provides evidence to inform management decisions about hospital nurse staffing.
Meyer
Raquel M
RM
Nursing Health Services Research Unit, Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada. raquel.meyer@utoronto.ca
Wang
Sping
S
Li
Xiaoqiang
X
Thomson
Donna
D
O'Brien-Pallas
Linda
L
D000328:Adult; D000368:Aged; D003325:Coronary Care Units / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006272:Health Facility Environment / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D009509:New Brunswick; D017711:Nonlinear Dynamics; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D009864:Ontario; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D011446:Prospective Studies; D013598:Systems Theory; D016526:Workload / Q000706:statistics & numerical data