2.50
Hdl Handle:
http://hdl.handle.net/10755/157914
Type:
Presentation
Title:
Quality Care on Acute Inpatient Units
Abstract:
Quality Care on Acute Inpatient Units
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Blegen, Mary A., RN, PhD, FAAN
P.I. Institution Name:University of California San Francisco, Community Health Systems
Title:Professor
Contact Address:2 Koret #0608, San Francisco, CA, 94143, USA
Contact Telephone:415-476-2599
Co-Authors:Colleen Goode, RN, PhD, FAAN, Chief Nursing Officer; Shin Hye Park, Research Assistant; Joanne Spetz, Associate Professor; Thomas Vaughn, PhD, Associate Professor
Purpose/Aim: The purpose of this project was to determine the impact of direct care nurse staffing hours, measured as recommended by the NQF (hours per patient day and staff mix), on patient outcome indicators recommended by the NQF (failure to rescue, pressure ulcers) and by the Agency for Healthcare Research and Quality (Inpatient Quality Indicators (IHI), Patient Safety Indicators (PSI)). Background: Previous research studying the relationship between nurse staffing and patient outcomes has produced inconsistent findings in part due to the inability to link patient outcomes measured from discharge data with nurse staffing at the patient care unit level. This project obtained patient outcomes data and unit level staffing data for general units and separately for intensive care units to advance the knowledge in this area. Methods: This research project used two data sets created by the University Health System Consortium. The Clinical Data Set contained patient discharge data and the Operational Data Set contained nurse staffing at the level of the patient care unit. Risk adjusted outcomes were calculated using the AHRQ algorithms for IQIs and PSIs. Staffing data were calculated per patient day adjusted for short stay and observation patients. Regression with Robust Standard Errors was used to estimate the models controlling for nesting within hospitals. Results: A total of 57 hospitals participated in the project, most of which contributed 4 quarters of data. Controlling for hospital case-mix index, technology, teaching status, and safety net status, nurse staffing on general units was related to lower rates of pressure ulcers, failure to rescue, and length of stay. Staffing on intensive care units was related with lower pressure ulcers, failure to rescue, and post-op sepsis. Implications: Higher nurse staffing levels on both general units and on intensive care units was related to lower rates of adverse outcomes. Nursing's capacity to identify and respond to patients at risk for developing pressure ulcers, sepsis, and other complication that could cause death and disability as well as increased costs of care is of increasing importance.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleQuality Care on Acute Inpatient Unitsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157914-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Quality Care on Acute Inpatient Units</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Blegen, Mary A., RN, PhD, FAAN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California San Francisco, Community Health Systems</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2 Koret #0608, San Francisco, CA, 94143, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">415-476-2599</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Mary.Blegen@nursing.ucsf.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Colleen Goode, RN, PhD, FAAN, Chief Nursing Officer; Shin Hye Park, Research Assistant; Joanne Spetz, Associate Professor; Thomas Vaughn, PhD, Associate Professor</td></tr><tr><td colspan="2" class="item-abstract">Purpose/Aim: The purpose of this project was to determine the impact of direct care nurse staffing hours, measured as recommended by the NQF (hours per patient day and staff mix), on patient outcome indicators recommended by the NQF (failure to rescue, pressure ulcers) and by the Agency for Healthcare Research and Quality (Inpatient Quality Indicators (IHI), Patient Safety Indicators (PSI)). Background: Previous research studying the relationship between nurse staffing and patient outcomes has produced inconsistent findings in part due to the inability to link patient outcomes measured from discharge data with nurse staffing at the patient care unit level. This project obtained patient outcomes data and unit level staffing data for general units and separately for intensive care units to advance the knowledge in this area. Methods: This research project used two data sets created by the University Health System Consortium. The Clinical Data Set contained patient discharge data and the Operational Data Set contained nurse staffing at the level of the patient care unit. Risk adjusted outcomes were calculated using the AHRQ algorithms for IQIs and PSIs. Staffing data were calculated per patient day adjusted for short stay and observation patients. Regression with Robust Standard Errors was used to estimate the models controlling for nesting within hospitals. Results: A total of 57 hospitals participated in the project, most of which contributed 4 quarters of data. Controlling for hospital case-mix index, technology, teaching status, and safety net status, nurse staffing on general units was related to lower rates of pressure ulcers, failure to rescue, and length of stay. Staffing on intensive care units was related with lower pressure ulcers, failure to rescue, and post-op sepsis. Implications: Higher nurse staffing levels on both general units and on intensive care units was related to lower rates of adverse outcomes. Nursing's capacity to identify and respond to patients at risk for developing pressure ulcers, sepsis, and other complication that could cause death and disability as well as increased costs of care is of increasing importance.</td></tr></table>en_GB
dc.date.available2011-10-26T20:19:35Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:19:35Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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