Associations Between Characteristics of the Nurse Work Environment and Nurse-Sensitive Patient Outcomes in Hospitals: A Systematic Review of Literature

2.50
Hdl Handle:
http://hdl.handle.net/10755/290963
Category:
Abstract
Type:
Presentation
Title:
Associations Between Characteristics of the Nurse Work Environment and Nurse-Sensitive Patient Outcomes in Hospitals: A Systematic Review of Literature
Author(s):
Stalpers, Dewi
Lead Author STTI Affiliation:
Rho Chi-at-Large
Author Details:
Dewi Stalpers, RN, MSc, d.stalpers@antoniusziekenhuis.nl
Abstract:

Poster presented on Friday, April 12, 2013, Saturday, April 13, 2013

Objective: To systematically review literature on associations between characteristics of the nurse work environment and nurse-sensitive patient outcomes in hospitals.

Methods: Included were peer-reviewed quantitative studies published between 2004 and 2012. The search was performed in Medline (PubMed), Cochrane, Embase, and CINAHL. Thirty studies were selected, using previously defined inclusion criteria and the Dutch version of Cochrane’s critical appraisal instrument to assess methodological quality. Cohen’s d was used to calculate effect sizes for three measures of nurse staffing.

Results: The review shows that evidence on associations between nurse work environment and nurse-sensitive outcomes is limited and often does not provide clear-cut conclusions. The meta-analysis showed small effect sizes; for pressure ulcers d= +0.21 and for patient falls d= -0.20. Increasing the hours of care performed by registered nurses and higher proportions of registered nurses were associated with less fall incidents with effect sizes of respectively d= -0.31 and d = -0.25. In contrast, increasing the total nursing hours of care was associated with higher pressure ulcers rates (d= +0.35). Characteristics of nurse work environment other than nurse staffing which showed significant effects were: i) workload; higher workload increased rates of falls and pressure ulcers, ii) teamwork; positive communication between nurses and physicians were associated with less patient falls and lower rates of pressure ulcers, and iii) experience; lower levels of experience related to more patient falls and higher rates of pressure ulcers.

Conclusion: In this review only limited evidence was found for associations between nurse-sensitive patient outcomes and staffing and other characteristics of the nurse-work environment. Fundamental methodological issues (e.g. unclear samples), major contribution of cross-sectional designs and the large diversity on outcome measures may be explanatory for these results. Future longitudinal research is necessary to find more strong and causal evidence.

Keywords:
work environment; nurse-sensitive patient outcomes; review
Repository Posting Date:
13-May-2013
Date of Publication:
13-May-2013
Conference Date:
2013
Conference Name:
Creating Healthy Work Environments
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
Creating Healthy Work Environments. Held at the JW Marriott, Indianapolis
Note:
This is an abstract-only submission. If the author has submitted a full-text item related to this abstract, you may find it by browsing the repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleAssociations Between Characteristics of the Nurse Work Environment and Nurse-Sensitive Patient Outcomes in Hospitals: A Systematic Review of Literatureen_GB
dc.contributor.authorStalpers, Dewien_GB
dc.contributor.departmentRho Chi-at-Largeen_GB
dc.author.detailsDewi Stalpers, RN, MSc, d.stalpers@antoniusziekenhuis.nlen_GB
dc.identifier.urihttp://hdl.handle.net/10755/290963-
dc.description.abstract<p>Poster presented on Friday, April 12, 2013, Saturday, April 13, 2013</p><i>Objective: </i>To systematically review literature on associations between characteristics of the nurse work environment and nurse-sensitive patient outcomes in hospitals. <p><i>Methods:</i><b> </b>Included were<b> </b>peer-reviewed quantitative studies published between 2004 and 2012.<b> </b>The search was performed in Medline (PubMed), Cochrane, Embase, and CINAHL. Thirty studies were selected, using previously defined inclusion criteria and the Dutch version of Cochrane&rsquo;s critical appraisal instrument to assess methodological quality. Cohen&rsquo;s <i>d </i>was used to calculate effect sizes for three measures of nurse staffing.<b></b><p><i>Results:</i> The review shows that evidence on associations between nurse work environment and nurse-sensitive outcomes is limited and often does not provide clear-cut conclusions. The meta-analysis showed small effect sizes; for pressure ulcers <i>d= +</i>0.21 and for patient falls <i>d</i>= -0.20. Increasing the hours of care performed by registered nurses and higher proportions of registered nurses were associated with less fall incidents with effect sizes of respectively <i>d</i>= -0.31 and <i>d </i>= -0.25. In contrast, increasing the total nursing hours of care was associated with higher pressure ulcers rates (<i>d</i>= +0.35). Characteristics of nurse work environment other than nurse staffing which showed significant effects were: i) workload; higher workload increased rates of falls and pressure ulcers, ii) teamwork; positive communication between nurses and physicians were associated with less patient falls and lower rates of pressure ulcers, and iii) experience; lower levels of experience related to more patient falls and higher rates of pressure ulcers. <b></b><p><i>Conclusion:</i><b> </b>In this review only limited evidence was found for associations between nurse-sensitive patient outcomes and staffing and other characteristics of the nurse-work environment. Fundamental methodological issues (e.g. unclear samples), major contribution of cross-sectional designs and the large diversity on outcome measures may be explanatory for these results. Future longitudinal research is necessary to find more strong and causal evidence.en_GB
dc.subjectwork environmenten_GB
dc.subjectnurse-sensitive patient outcomesen_GB
dc.subjectreviewen_GB
dc.date.available2013-05-13T10:23:45Z-
dc.date.issued2013-05-13-
dc.date.accessioned2013-05-13T10:23:45Z-
dc.conference.date2013en_GB
dc.conference.nameCreating Healthy Work Environmentsen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.descriptionCreating Healthy Work Environments. Held at the JW Marriott, Indianapolisen_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item related to this abstract, you may find it by browsing the repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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