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Patient turnover and the relationship between nurse staffing and patient outcomes

Authors

  • Shin Hye Park,

    Corresponding author
    1. National Database of Nursing Quality Indicators, School of Nursing, University of Kansas Medical Center, 3901 Rainbow Blvd., MS 3060, Kansas City, KS 66160
    • National Database of Nursing Quality Indicators, School of Nursing, University of Kansas Medical Center, 3901 Rainbow Blvd., MS 3060, Kansas City, KS 66160
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    • Postdoctoral Fellow.

  • Mary A. Blegen,

    1. Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA
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    • Professor Emerita.

  • Joanne Spetz,

    1. Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA
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    • Professor.

  • Susan A. Chapman,

    1. Department of Social and Behavioral Sciences, School of Nursing, University of California San Francisco, San Francisco, CA
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    • Associate Professor, Chief Executive.

  • Holly De Groot

    1. Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA
    2. Catalyst Systems, LLC, Novato, CA
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    • Clinical Professor, University of California San Francisco; Chief Executive Officer, Catalyst Systems.


  • Funding from the Robert Wood Johnson Foundation: Interdisciplinary Nursing Quality Research Initiative. This study was approved under an exemption by the Committee on Human Research at the University of California, San Francisco, because of the use of a de-identified secondary analysis.

Abstract

High patient turnover (patient throughput generated by admissions, discharges, and transfers) contributes to increased demands and resources for care. We examined how the relationship between registered nurse (RN) staffing and failure-to-rescue (FTR) varied with patient turnover levels by analyzing quarterly data from the University HealthSystem Consortium. The data included 42 hospitals, representing 759 nursing units and about 1 million inpatients. Higher RN staffing was associated with lower FTR. When patient turnover increased from 48.6% to 60.7% on nonintensive units (non-ICUs), the beneficial effect of non-ICU RN staffing on FTR was reduced by 11.5%. RN staffing should be adjusted according to patient turnover because turnover increases patient care demand beyond that presented by patient count, and outcomes may be adversely affected. © 2012 Wiley Periodicals, Inc. Res Nurs Health 35:277–288, 2012

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