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Papers on “nurse staffing ratios patient outcomes mortality”

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1. Dexamethasone in Hospitalized Patients with Covid-19

   The RECOVERY Collaborative Group · 2020 · New England Journal of Medicine · 10,161 cites

   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

2. Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries

   Giacomo Bellani, John G. Laffey, Tài Pham, et al. · 2016 · JAMA · 5,986 cites

   IMPORTANCE: Limited information exists about the epidemiology, recognition, management, and outcomes of patients with the acute respiratory distress syndrome (ARDS). OBJECTIVES: To evaluate intensive care unit (ICU) incidence and outcome of ARDS and to assess clinician recognition, ventilation management, and use of adjuncts-for example prone positioning-in routine clinical practice for patients fulfilling the ARDS Berlin Definition. DESIGN, SETTING, AND PARTICIPANTS: The Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients undergoing invasive or noninvasive ventilatio

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

   Linda H. Aiken · 2002 · JAMA · 5,242 cites

   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

4. 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 · 2,777 cites

   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

5. 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 · 2,258 cites

   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

6. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study

   Linda H. Aiken, Douglas M. Sloane, Luk Bruyneel, et al. · 2014 · The Lancet · 2,240 cites

7. Educational Levels of Hospital Nurses and Surgical Patient Mortality

   Linda H. Aiken · 2003 · JAMA · 1,738 cites

   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

8. The Association of Registered Nurse Staffing Levels and Patient Outcomes: Systematic Review and Meta-Analysis

   R. Kane, T. Shamliyan, C. Mueller, et al. · 2007 · Medical Care · 1,199 cites

   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