Learning Objective 1: identify factors that affect patient safety in medical-surgical units of acute care hospitals.
Learning Objective 2: discuss implications of research findings for the practice of nursing administration including budgeting, staffing, and tracking patient outcomes.
Methods: A quantitative, cross-sectional method was used, and a sample of 35,000 patients from 11 medical-surgical units was drawn. Data were extracted from administrative databases from a 2-year period. Patient-level and unit-level data were analyzed using hierarchical linear modeling in HLM 6.06.
Results: Findings from the study showed nurse staffing is predictive of patient length of stay (LOS) and adverse events when controlling for patient age and complication index. The predictive model showed that for every 0.6 hour increase in RN hours, there would be a 10.3% decrease in LOS. Likewise, with every 1% increase in the proportion of RNs, there would be a 3% decrease in LOS. Staffing was related to adverse events: for every 1% increase in the proportion of RNs, there was a 3% decrease in adverse events. Mortality was not predicted by nurse staffing.
Conclusion: The results of this study, along with others reported in the literature, show evidence of relationships between staffing and patient outcomes. Nurse administrators should consider research findings when making budgeting and staffing decisions.