At the time this research was conducted Dr. Kovner was Senior Scholar, Center for Primary Care Research, Agency for Health Care Policy and Research (AHCPR). This paper does not represent the policy of AHCPR. The views expressed are those of the authors and no official endorsement by AHCPR is intended or should be inferred.
Nurse Staffing Levels and Adverse Events Following Surgery in U.S. Hospitals
Article first published online: 2 OCT 2007
Image: the Journal of Nursing Scholarship
Volume 30, Issue 4, pages 315–321, December 1998
How to Cite
Kovner, C. and Gergen, P. J. (1998), Nurse Staffing Levels and Adverse Events Following Surgery in U.S. Hospitals. Image: the Journal of Nursing Scholarship, 30: 315–321. doi: 10.1111/j.1547-5069.1998.tb01326.x
- Issue published online: 2 OCT 2007
- Article first published online: 2 OCT 2007
- Accepted for publication June 10, 1998.
- adverse events
Purpose: To examine the relationship between nurse staffing and selected adverse events hypothesized to be sensitive to nursing care, while controlling for related hospital characteristics. Efforts in the United States to reduce hospital costs, resulting in strategies to use fewer nurses, have stimulated extensive debate but little evaluation.
Design: Survey using data from a 20% stratified probability sample to approximate U.S. community hospitals. The sample included 589 acute-care hospitals in 10 states.
Methods: Discharge data from 1993 for patients aged 18 years and over were used to create hospital-level adverse event indicators. These hospital-level data were matched to American Hospital Association data on community hospital characteristics, including nurse staffing, to examine the relationship between nurse staffing and adverse events.
Results: A large and significant inverse relationship was found between full-time-equivalent RNs per adjusted inpatient day (RNAPD) and urinary tract infections after major surgery (p<.0001) as well as pneumonia after major surgery (p<.001). A significant but less robust inverse relationship was found between RNAPD and thrombosis after major surgery (p<.01), as well as pulmonary compromise after major surgery (p<.05).
Conclusions: Inverse relationships between nurse staffing and these adverse events provide information for managers to use when redesigning and restructuring the clinical workforce employed in providing inpatient care.