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Nurse Staffing and Patient Outcomes in Inpatient Rehabilitation Settings

Authors

  • Audrey Nelson PhD RN FAAN,

    Director, Corresponding authorSearch for more papers by this author
    • Audrey Nelson, PhD RN FAAN, is a director of Patient Safety Center of Inquiry at James A. Haley Veterans Administration Medical Center in Tampa, FL.

  • Gail Powell-Cope PhD RN FAAN,

    DirectorSearch for more papers by this author
    • Gail Powell-Cope, PhD RN FAAN, is a director of RR&D Research Enhancement Award Program at James A. Haley Veterans Administration Medical Center in Tampa, FL.

  • Polly Palacios MSPH,

    StatisticianSearch for more papers by this author
    • Polly Palacios, MSPH, is a Statistician at Patient Safety Center of Inquiry at James A. Haley Veterans Administration Medical Center in Tampa, FL.

  • Stephen L. Luther PhD,

    Associate DirectorSearch for more papers by this author
    • Stephen L. Luther, PhD, is an associate director of Research Methods and Evaluation at Patient Safety Center of Inquiry at James A. Haley Veterans Administration Medical Center in Tampa, FL.

  • Terrie Black MBA BSN RN BC CRRN,

    Chief Clinical OfficerSearch for more papers by this author
    • Terrie Black, MBA BSN RN BC CRRN, is a chief clinical officer at Uniform Data System for Medical Rehabilitation in Amherst, NY.

  • Troy Hillman BS,

    Development CoordinatorSearch for more papers by this author
    • Troy Hillman, BS, is a report development coordinator at Uniform Data System for Medical Rehabilitation in Amherst, NY.

  • Beth Christiansen BSN RN,

    Associate Product ManagerSearch for more papers by this author
    • Beth Christiansen, BSN RN, is UDS-PRO® associate product manager at Uniform Data System for Medical Rehabilitation in Amherst, NY.

  • Paul Nathenson RN CRRN MPA,

    Vice PresidentSearch for more papers by this author
    • Paul Nathenson, RN CRRN MPA, is the vice president of Clinical Services at Madonna Rehabilitation Hospital in Lincoln, NE.

  • Jan Coleman Gross PhD ARNP-S

    ConsultantSearch for more papers by this author
    • Jan Coleman Gross, PhD ARNP-S, is a consultant at Cardinal Hill Rehabilitation Hospital and an assistant professor at UK College of Nursing in Lexington, KY.


Patient Safety Center, 11605 N. Nebraska Avenue, Tampa, FL 33612, or audrey.nelson@va.gov.

Abstract

In rehabilitation nursing, the patient classification systems or acuity models and nurse-staffing ratios are not supported by empirical evidence. Moreover, there are no studies published characterizing nursing hours per patient day, proportion of RN staff, and impact of agency nurses in inpatient rehabilitation settings. The purpose of this prospective observational study was to describe rehabilitation nurse staffing patterns, to validate the impact of rehabilitation nursing on patient outcomes, and to test whether existing patient measures on severity and outcomes in rehabilitation could be used as a proxy for burden of care to predict rehabilitation nurse staffing ceilings and daily nurse staffing requirements. A total of 54 rehabilitation facilities in the United States, stratified by geography, were randomly selected to participate in the study.

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