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Learning Objective 1: The learner will be able to identify the correlation among nursing care hours, use of temporary nursing staff, and nurse turnover.
Learning Objective 2: The learner will be able to understand how nursing care hours, use of temporary nursing staff, and nurse turnover jointly affect patient outcomes.
Shortages in the nursing workforce are expected to have severe effects on quality of patient care in the U.S. Nursing shortages often lead to suboptimal staffing characteristics, which include lower nursing care hours, higher turnover, and higher use of temporary nursing staff. Previously, the impact of these suboptimal nurse staffing characteristics were distinctively evaluated. This study examines the extent to which nurse staffing characteristics jointly affect patient outcomes with both concurrent and lagged impact approaches.
Methods:
A secondary data analysis was conducted with data from the Western New York Center for Nursing Workforce and Quality. This data consisted of nursing unit level data on 109 nursing units from 8 hospitals located in New York State. Patient outcomes include patient falls, pressure ulcers, ventilator-associated pneumonia, central line associated blood stream infection and physical restraint prevalence. Nurse staffing was measured by nursing care hours per patient day, use of temporary nursing staff, and nurse turnover data. All patient outcome and nurse staffing data were collected quarterly for a year. Other hospital and nursing unit characteristics were also collected.
Results:
The quarterly mean of patient falls was 3.5 per 1,000 patient days. The restraint prevalence rate and pressure ulcer rate were 2% and 21%, respectively. The mean of RN nursing care hours per patient day was 7.4. The mean of nurse turnover rate was 7.2 %. In further analyses, we will test to what extent all of these suboptimal nurse staffing characteristics affect patient outcomes.
Conclusion:
The findings of this study will show whether suboptimal nurse staffing affect patient quality of care jointly. The ultimate goal of nurse staffing strategy is to provide quality of patient care with appropriate staffing resources. We will discuss how these comprehensive nurse staffing characteristics can enrich to measure nurse staffing and what effort should be made for successful staffing strategies.