Doctoral Dissertation Research: The Impact of Nurse Staffing on the Quality of Patient Care

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9809464 LeClere The objective of this dissertation improvement award is to assess the recent changes in hospital nursing staff and their impact on the quality of patient care. The staffing changes examined are levels of nursing staff per acuity-adjusted patient day, and nursing staff mix. Quality is measured through three patient outcomes indicators: mortality, readmissions and infection rates. Factors controlled for include patient acuity and hospital characteristics. Three secondary data sets are utilized, two from yearly staffing and utilization records from all Pennsylvania hospitals for 1992-1996, and the third from all patient records in these hospitals over the same period. Two methods are utilized to analyze the data. Repeated cross-sectional analysis assesses the relationship of patient outcomes to nurse staffing. Time series analysis assesses the percent change in outcomes given the changes in staffing. This research is of immediate importance. Since 1994, nurses and patients have perceived a decline in staffing levels and in the quality of patient care. Yet there has been no large-scale study of the changes. Past research has been cross-sectional only, focusing on patient mortality. In 1996, the Institute of Medicine reported a lack of research in this area and recommended its funding.