title: Influence of unit-level staffing on medication errors and falls in military hospitals.
abstract: This study examined unit-level associations of nurse staffing and workload, and the effect of the practice environment on adverse patient events. A secondary analysis was conducted of a longitudinal data set of 23 Army inpatient units from the Military Nursing Outcomes Database. Generalized Linear Mixed Modeling accommodated nested, nonparametric data. Staff category was found to be a significant predictor of medication errors and patient falls, but the relationship varied by unit type. Patient census had no effect on either outcome; however, a higher patient acuity was associated with an increase in both adverse events. The nursing practice environment mediated medication errors but not falls, in all unit types. Skill mix is important; however, additional components of staffing need consideration in producing positive patient outcomes.
authors.affiliation: Walter Reed Army Medical Center, Arlington, VA, USA. sara.sproat@us.army.mil
authors.forename: Sara
authors.initials: S
authors.lastname: Breckenridge-Sproat
authors.forename: Meg
authors.initials: M
authors.lastname: Johantgen
authors.forename: Patricia
authors.initials: P
authors.lastname: Patrician
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D016208:Databases, Factual / Q000706:statistics & numerical data; D006772:Hospitals, Military / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008508:Medication Errors / Q000706:statistics & numerical data*; D008888:Military Nursing / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*