Nurse–Patient Ratios as a Patient Safety Strategy
@article{Shekelle2013NursePatientRA,
title={Nurse–Patient Ratios as a Patient Safety Strategy},
author={Paul Shekelle},
journal={Annals of Internal Medicine},
year={2013},
volume={158},
pages={404 - 409}
}A small percentage of patients die during hospitalization or shortly thereafter, and it is widely believed that more or better nursing care could prevent some of these deaths. The author systematically reviewed the evidence about nurse staffing ratios and in-hospital death through September 2012. From 550 titles, 87 articles were reviewed and 15 new studies that augmented the 2 existing reviews were selected. The strongest evidence supporting a causal relationship between higher nurse staffing…
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References
SHOWING 1-10 OF 50 REFERENCES
Improving Nurse-to-Patient Staffing Ratios as a Cost-Effective Safety Intervention
- Medicine, Political ScienceMedical care
- 2005
As a patient safety intervention, patient-to-nurse ratios of 4:1 are reasonably cost-effective and in the range of other commonly accepted interventions.
Outcomes of variation in hospital nurse staffing in English hospitals: cross-sectional analysis of survey data and discharge records.
- Medicine, Political ScienceInternational journal of nursing studies
- 2007
Nurse staffing levels and the incidence of mortality and morbidity in the adult intensive care unit: a literature review.
- MedicineAustralian critical care : official journal of the Confederation of Australian Critical Care Nurses
- 2012
Nurse staffing and inpatient hospital mortality.
- Medicine, Political ScienceThe New England journal of medicine
- 2011
Staffing of RNs below target levels was associated with increased mortality, which reinforces the need to match staffing with patients' needs for nursing care.
Effects of Hospital Care Environment on Patient Mortality and Nurse Outcomes
- Medicine, Political ScienceThe Journal of nursing administration
- 2009
Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments.
Nurse Staffing and Patient Safety in Hospitals: New Variable and Longitudinal Approaches
- MedicineNursing research
- 2012
A negative relationship between RN staffing and PSIs was strongly supported with failure to rescue and was weakly supported with decubitus ulcers, selected infections, and postoperative sepsis.
The Relationship Between Nurse Staffing and Patient Outcomes
- Medicine, Political ScienceThe Journal of nursing administration
- 2003
The ratio of total nurse staffing to patients was significantly related to in-hospital mortality in both partial and marginal analyses, controlling for patient characteristics, and the ratios were found to be the best predictor of in- hospital mortality among the four nurse staffing variables.
Educational levels of hospital nurses and surgical patient mortality.
- MedicineJAMA
- 2003
In hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates.
Nurse Staffing and Patient Mortality in Intensive Care Units
- Medicine, Political ScienceNursing research
- 2008
This study included 27,372 ICU patients discharged from 42 tertiary and 194 secondary hospitals to examine the relationship between nurse staffing and patient mortality in Korean intensive care units (ICUs).
The Association of Registered Nurse Staffing Levels and Patient Outcomes: Systematic Review and Meta-Analysis
- Medicine, Political ScienceMedical care
- 2007
Increased RN staffing was associated with lower hospital related mortality in intensive care units (ICUs) and lower odds of hospitalrelated mortality and adverse patient events and patient and hospital characteristics, including hospitals’ commitment to quality of medical care, likely contribute to the actual causal pathway.