The association of shift-level nurse staffing with adverse patient events.
OBJECTIVE
The objective of this study was to demonstrate the association between nurse staffing and adverse events at the shift level.


BACKGROUND
Despite a growing body of research linking nurse staffing and patient outcomes, the relationship of staffing to patient falls and medication errors remains equivocal, possibly due to dependence on aggregated data.


METHODS
Thirteen military hospitals participated in creating a longitudinal nursing outcomes database to monitor nurse staffing, patient falls and medication errors, and other outcomes. Unit types were analyzed separately to stratify patient and nurse staffing characteristics. Bayesian hierarchical logistic regression modeling was used to examine associations between staffing and adverse events.


RESULTS
RN skill mix, total nursing care hours, and experience, measured by a proxy variable, were associated with shift-level adverse events.


CONCLUSIONS
Consideration must be given to nurse staffing and experience levels on every shift.
University of Alabama at Birmingham, School of Nursing, Birmingham, AL 35294-1210, USA. ppatrici@uab.edu
Patricia A
PA
Patrician
Lori
L
Loan
Mary
M
McCarthy
Moshe
M
Fridman
Nancy
N
Donaldson
Mona
M
Bingham
Laura R
LR
Brosch
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D001499:Bayes Theorem; D016208:Databases, Factual; D006772:Hospitals, Military; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008508:Medication Errors / Q000451:nursing / Q000517:prevention & control / Q000706:statistics & numerical data*; D008888:Military Nursing; D015999:Multivariate Analysis; D009718:Nurse Administrators; D015401:Nursing Administration Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000600:supply & distribution*; D017063:Outcome Assessment, Health Care; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000458:organization & administration; D012308:Risk Management / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D000078329:Workforce; D016526:Workload / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology