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Research papers on Nurse staffing and patient outcomes

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  1. Dexamethasone in Hospitalized Patients with Covid-19

    The RECOVERY Collaborative Group · 2020 · New England Journal of Medicine · 10,164 citations

    BACKGROUND: Coronavirus disease 2019 (Covid-19) is associated with diffuse lung damage. Glucocorticoids may modulate inflammation-mediated lung injury and thereby reduce progression to respiratory failure and death. METHODS: In this controlled, open-label trial comparing a range of possible treatments in patients who were hospitalized with Covid-19, we randomly assigned patients to receive oral or intravenous dexamethasone (at a dose of 6 mg once daily) for up to 10 days or to receive usual care alone. The primary outcome was 28-day mortality. Here, we report the final results of this assessment. RESULTS: A total of 2104 patients were assigned to receive dexamethasone and 4321 to receive usu

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  2. Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction

    Linda H. Aiken · 2002 · JAMA · 5,245 citations

    CONTEXT: The worsening hospital nurse shortage and recent California legislation mandating minimum hospital patient-to-nurse ratios demand an understanding of how nurse staffing levels affect patient outcomes and nurse retention in hospital practice. OBJECTIVE: To determine the association between the patient-to-nurse ratio and patient mortality, failure-to-rescue (deaths following complications) among surgical patients, and factors related to nurse retention. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analyses of linked data from 10 184 staff nurses surveyed, 232 342 general, orthopedic, and vascular surgery patients discharged from the hospital between April 1, 1998, and November 3

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  3. A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). The SUPPORT Principal Investigators

    Alfred F. Connors, Neal V. Dawson, Norman A. Desbiens, et al. · 1995 · JAMA · 2,779 citations

    OBJECTIVES: To improve end-of-life decision making and reduce the frequency of a mechanically supported, painful, and prolonged process of dying. DESIGN: A 2-year prospective observational study (phase I) with 4301 patients followed by a 2-year controlled clinical trial (phase II) with 4804 patients and their physicians randomized by specialty group to the intervention group (n = 2652) or control group (n = 2152). SETTING: Five teaching hospitals in the United States. PATIENTS: A total of 9105 adults hospitalized with one or more of nine life-threatening diagnoses; an overall 6-month mortality rate of 47%. INTERVENTION: Physicians in the intervention group received estimates of the likelihoo

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  4. Nurse-Staffing Levels and the Quality of Care in Hospitals

    Jack Needleman, Peter I. Buerhaus, Soeren Mattke, et al. · 2002 · New England Journal of Medicine · 2,268 citations

    BACKGROUND: It is uncertain whether lower levels of staffing by nurses at hospitals are associated with an increased risk that patients will have complications or die. METHODS: We used administrative data from 1997 for 799 hospitals in 11 states (covering 5,075,969 discharges of medical patients and 1,104,659 discharges of surgical patients) to examine the relation between the amount of care provided by nurses at the hospital and patients' outcomes. We conducted regression analyses in which we controlled for patients' risk of adverse outcomes, differences in the nursing care needed for each hospital's patients, and other variables. RESULTS: The mean number of hours of nursing care per patien

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  6. Educational Levels of Hospital Nurses and Surgical Patient Mortality

    Linda H. Aiken · 2003 · JAMA · 1,741 citations

    CONTEXT: Growing evidence suggests that nurse staffing affects the quality of care in hospitals, but little is known about whether the educational composition of registered nurses (RNs) in hospitals is related to patient outcomes. OBJECTIVE: To examine whether the proportion of hospital RNs educated at the baccalaureate level or higher is associated with risk-adjusted mortality and failure to rescue (deaths in surgical patients with serious complications). DESIGN, SETTING, AND POPULATION: Cross-sectional analyses of outcomes data for 232 342 general, orthopedic, and vascular surgery patients discharged from 168 nonfederal adult general Pennsylvania hospitals between April 1, 1998, and Novemb

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  7. The Association of Registered Nurse Staffing Levels and Patient Outcomes

    Robert L Kane, Tatyana Shamliyan, Christine Mueller, et al. · 2007 · Medical Care · 1,111 citations

    OBJECTIVE: To examine the association between registered nurse (RN) staffing and patient outcomes in acute care hospitals. STUDY SELECTION: Twenty-eight studies reported adjusted odds ratios of patient outcomes in categories of RN-to-patient ratio, and met inclusion criteria. Information was abstracted using a standardized protocol. DATA SYNTHESIS: Random effects models assessed heterogeneity and pooled data from individual studies. Increased RN staffing was associated with lower hospital related mortality in intensive care units (ICUs) [odds ratios (OR), 0.91; 95% confidence interval (CI), 0.86-0.96], in surgical (OR, 0.84; 95% CI, 0.80-0.89), and in medical patients (OR, 0.94; 95% CI, 0.94

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  8. Nurse Staffing and Inpatient Hospital Mortality

    Jack Needleman, Peter I. Buerhaus, V. Shane Pankratz, et al. · 2011 · New England Journal of Medicine · 945 citations

    BACKGROUND: Cross-sectional studies of hospital-level administrative data have shown an association between lower levels of staffing of registered nurses (RNs) and increased patient mortality. However, such studies have been criticized because they have not shown a direct link between the level of staffing and individual patient experiences and have not included sufficient statistical controls. METHODS: We used data from a large tertiary academic medical center involving 197,961 admissions and 176,696 nursing shifts of 8 hours each in 43 hospital units to examine the association between mortality and patient exposure to nursing shifts during which staffing by RNs was 8 hours or more below th

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  9. Effects of Nurse Staffing and Nurse Education on Patient Deaths in Hospitals With Different Nurse Work Environments

    Linda H. Aiken, Jeannie P. Cimiotti, Douglas M. Sloane, et al. · 2011 · Medical Care · 827 citations

    CONTEXT: Better hospital nurse staffing, more educated nurses, and improved nurse work environments have been shown to be associated with lower hospital mortality. Little is known about whether and under what conditions each type of investment works better to improve outcomes. OBJECTIVE: To determine the conditions under which the impact of hospital nurse staffing, nurse education, and work environment are associated with patient outcomes. DESIGN, SETTING, AND PARTICIPANTS: Outcomes of 665 hospitals in 4 large states were studied through linked data from hospital discharge abstracts for 1,262,120 general, orthopedic, and vascular surgery patients, a random sample of 39,038 hospital staff nur

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  10. Nurse???Patient Ratios

    T. Lang, Margaret Hodge, Valerie Olson, et al. · 2004 · JONA The Journal of Nursing Administration · 432 citations

    OBJECTIVE: To determine whether the peer-reviewed literature supports specific, minimum nurse-patient ratios for acute care hospitals and whether nurse staffing is associated with patient, nurse employee, or hospital outcomes. BACKGROUND: Hospital care may be compromised by forces that have increased patient acuity, reduced the ratio of caregivers to patients, and lowered the level of training of these caregivers. METHODS: We systematically reviewed studies of the effects of nurse staffing on patient, nurse employee, and hospital outcomes published between 1980 and 2003 to determine whether they could guide the setting of minimum licensed nurse-patient ratios in acute care hospitals. RESULTS

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  14. Minimum Nurse-to-Patient Ratios Improve Staffing, Patient Outcomes

    Karen Rosenberg · 2021 · AJN, American Journal of Nursing · 7 citations

    According to this study: Minimum nurse-to-patient staffing ratios not only improve nurse staffing and patient outcomes but also yield a good return on investment.Staffing improvements of one fewer patient per nurse led to improvements in mortality, readmissions, and length of stay.

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