Case for hospital nurse-to-patient ratio legislation in Queensland, Australia, hospitals: an observational study
ObjectivesTo determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients a...
Saved in:
| Published in: | BMJ open Vol. 10; no. 9; p. e036264 |
|---|---|
| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
British Medical Journal Publishing Group
06.09.2020
BMJ Publishing Group LTD BMJ Publishing Group |
| Series: | Original research |
| Subjects: | |
| ISSN: | 2044-6055, 2044-6055 |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | ObjectivesTo determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses.DesignAnalysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data.SettingPublic hospitals in Queensland.Participants4372 medical-surgical nurses and 146 456 patients in 68 public hospitals.Main outcome measures30-day mortality, quality and safety indicators, nurse outcomes including emotional exhaustion and job dissatisfaction.ResultsMedical-surgical nurse-to-patient ratios before implementation of ratio legislation varied significantly across hospitals (mean 5.52 patients per nurse; SD=2.03). After accounting for patient characteristics and hospital size, each additional patient per nurse was associated with 12% higher odds of 30-day mortality (OR=1.12; 95% CI 1.01 to 1.26). Each additional patient per nurse was associated with poorer outcomes for nurses including 15% higher odds of emotional exhaustion (OR=1.15; 95% CI 1.07 to 1.23) and 14% higher odds of job dissatisfaction (OR=1.14; 95% CI 1.02 to 1.28), as well as higher odds of concerns about quality of care (OR=1.12; 95% CI 1.01 to 1.25) and patient safety (OR=1.32; 95% CI 1.11 to 1.57).ConclusionsBefore ratios were implemented, nurse staffing varied considerably across Queensland hospital medical-surgical wards and higher nurse workloads were associated with patient mortality, low quality of care, nurse emotional exhaustion and job dissatisfaction. The considerable variation across hospitals and the link with outcomes suggests that taking action to improve staffing levels was prudent. |
|---|---|
| AbstractList | ObjectivesTo determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses.DesignAnalysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data.SettingPublic hospitals in Queensland.Participants4372 medical-surgical nurses and 146 456 patients in 68 public hospitals.Main outcome measures30-day mortality, quality and safety indicators, nurse outcomes including emotional exhaustion and job dissatisfaction.ResultsMedical-surgical nurse-to-patient ratios before implementation of ratio legislation varied significantly across hospitals (mean 5.52 patients per nurse; SD=2.03). After accounting for patient characteristics and hospital size, each additional patient per nurse was associated with 12% higher odds of 30-day mortality (OR=1.12; 95% CI 1.01 to 1.26). Each additional patient per nurse was associated with poorer outcomes for nurses including 15% higher odds of emotional exhaustion (OR=1.15; 95% CI 1.07 to 1.23) and 14% higher odds of job dissatisfaction (OR=1.14; 95% CI 1.02 to 1.28), as well as higher odds of concerns about quality of care (OR=1.12; 95% CI 1.01 to 1.25) and patient safety (OR=1.32; 95% CI 1.11 to 1.57).ConclusionsBefore ratios were implemented, nurse staffing varied considerably across Queensland hospital medical-surgical wards and higher nurse workloads were associated with patient mortality, low quality of care, nurse emotional exhaustion and job dissatisfaction. The considerable variation across hospitals and the link with outcomes suggests that taking action to improve staffing levels was prudent. To determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses.OBJECTIVESTo determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses.Analysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data.DESIGNAnalysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data.Public hospitals in Queensland.SETTINGPublic hospitals in Queensland.4372 medical-surgical nurses and 146 456 patients in 68 public hospitals.PARTICIPANTS4372 medical-surgical nurses and 146 456 patients in 68 public hospitals.30-day mortality, quality and safety indicators, nurse outcomes including emotional exhaustion and job dissatisfaction.MAIN OUTCOME MEASURES30-day mortality, quality and safety indicators, nurse outcomes including emotional exhaustion and job dissatisfaction.Medical-surgical nurse-to-patient ratios before implementation of ratio legislation varied significantly across hospitals (mean 5.52 patients per nurse; SD=2.03). After accounting for patient characteristics and hospital size, each additional patient per nurse was associated with 12% higher odds of 30-day mortality (OR=1.12; 95% CI 1.01 to 1.26). Each additional patient per nurse was associated with poorer outcomes for nurses including 15% higher odds of emotional exhaustion (OR=1.15; 95% CI 1.07 to 1.23) and 14% higher odds of job dissatisfaction (OR=1.14; 95% CI 1.02 to 1.28), as well as higher odds of concerns about quality of care (OR=1.12; 95% CI 1.01 to 1.25) and patient safety (OR=1.32; 95% CI 1.11 to 1.57).RESULTSMedical-surgical nurse-to-patient ratios before implementation of ratio legislation varied significantly across hospitals (mean 5.52 patients per nurse; SD=2.03). After accounting for patient characteristics and hospital size, each additional patient per nurse was associated with 12% higher odds of 30-day mortality (OR=1.12; 95% CI 1.01 to 1.26). Each additional patient per nurse was associated with poorer outcomes for nurses including 15% higher odds of emotional exhaustion (OR=1.15; 95% CI 1.07 to 1.23) and 14% higher odds of job dissatisfaction (OR=1.14; 95% CI 1.02 to 1.28), as well as higher odds of concerns about quality of care (OR=1.12; 95% CI 1.01 to 1.25) and patient safety (OR=1.32; 95% CI 1.11 to 1.57).Before ratios were implemented, nurse staffing varied considerably across Queensland hospital medical-surgical wards and higher nurse workloads were associated with patient mortality, low quality of care, nurse emotional exhaustion and job dissatisfaction. The considerable variation across hospitals and the link with outcomes suggests that taking action to improve staffing levels was prudent.CONCLUSIONSBefore ratios were implemented, nurse staffing varied considerably across Queensland hospital medical-surgical wards and higher nurse workloads were associated with patient mortality, low quality of care, nurse emotional exhaustion and job dissatisfaction. The considerable variation across hospitals and the link with outcomes suggests that taking action to improve staffing levels was prudent. To determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses. Analysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data. Public hospitals in Queensland. 4372 medical-surgical nurses and 146 456 patients in 68 public hospitals. 30-day mortality, quality and safety indicators, nurse outcomes including emotional exhaustion and job dissatisfaction. Medical-surgical nurse-to-patient ratios before implementation of ratio legislation varied significantly across hospitals (mean 5.52 patients per nurse; SD=2.03). After accounting for patient characteristics and hospital size, each additional patient per nurse was associated with 12% higher odds of 30-day mortality (OR=1.12; 95% CI 1.01 to 1.26). Each additional patient per nurse was associated with poorer outcomes for nurses including 15% higher odds of emotional exhaustion (OR=1.15; 95% CI 1.07 to 1.23) and 14% higher odds of job dissatisfaction (OR=1.14; 95% CI 1.02 to 1.28), as well as higher odds of concerns about quality of care (OR=1.12; 95% CI 1.01 to 1.25) and patient safety (OR=1.32; 95% CI 1.11 to 1.57). Before ratios were implemented, nurse staffing varied considerably across Queensland hospital medical-surgical wards and higher nurse workloads were associated with patient mortality, low quality of care, nurse emotional exhaustion and job dissatisfaction. The considerable variation across hospitals and the link with outcomes suggests that taking action to improve staffing levels was prudent. Objectives To determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses.Design Analysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data.Setting Public hospitals in Queensland.Participants 4372 medical-surgical nurses and 146 456 patients in 68 public hospitals.Main outcome measures 30-day mortality, quality and safety indicators, nurse outcomes including emotional exhaustion and job dissatisfaction.Results Medical-surgical nurse-to-patient ratios before implementation of ratio legislation varied significantly across hospitals (mean 5.52 patients per nurse; SD=2.03). After accounting for patient characteristics and hospital size, each additional patient per nurse was associated with 12% higher odds of 30-day mortality (OR=1.12; 95% CI 1.01 to 1.26). Each additional patient per nurse was associated with poorer outcomes for nurses including 15% higher odds of emotional exhaustion (OR=1.15; 95% CI 1.07 to 1.23) and 14% higher odds of job dissatisfaction (OR=1.14; 95% CI 1.02 to 1.28), as well as higher odds of concerns about quality of care (OR=1.12; 95% CI 1.01 to 1.25) and patient safety (OR=1.32; 95% CI 1.11 to 1.57).Conclusions Before ratios were implemented, nurse staffing varied considerably across Queensland hospital medical-surgical wards and higher nurse workloads were associated with patient mortality, low quality of care, nurse emotional exhaustion and job dissatisfaction. The considerable variation across hospitals and the link with outcomes suggests that taking action to improve staffing levels was prudent. |
| Author | Yates, Patsy McHugh, Matthew D Windsor, Carol Aiken, Linda H Douglas, Clint |
| AuthorAffiliation | 2 School of Nursing , Queensland University of Technology , Brisbane , Queensland , Australia 1 School of Nursing, Center for Health Outcomes and Policy Research , University of Pennsylvania , Philadelphia , Pennsylvania , USA 3 Metro North Hospital and Health Service , Royal Brisbane and Women’s Hospital , Herston , Queensland , Australia |
| AuthorAffiliation_xml | – name: 2 School of Nursing , Queensland University of Technology , Brisbane , Queensland , Australia – name: 3 Metro North Hospital and Health Service , Royal Brisbane and Women’s Hospital , Herston , Queensland , Australia – name: 1 School of Nursing, Center for Health Outcomes and Policy Research , University of Pennsylvania , Philadelphia , Pennsylvania , USA |
| Author_xml | – sequence: 1 givenname: Matthew D orcidid: 0000-0002-1263-0697 surname: McHugh fullname: McHugh, Matthew D email: mchughm@nursing.upenn.edu organization: School of Nursing, Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA – sequence: 2 givenname: Linda H surname: Aiken fullname: Aiken, Linda H organization: School of Nursing, Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA – sequence: 3 givenname: Carol surname: Windsor fullname: Windsor, Carol organization: School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia – sequence: 4 givenname: Clint surname: Douglas fullname: Douglas, Clint organization: Metro North Hospital and Health Service, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia – sequence: 5 givenname: Patsy orcidid: 0000-0001-8946-8504 surname: Yates fullname: Yates, Patsy organization: School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32895270$$D View this record in MEDLINE/PubMed |
| BookMark | eNp9kk1r3DAQhk1JadI0v6BQDL30EDeSLclSD4Gw9CMQKIX2LGRpvNHilVzJDuTfdzbepEkO0UWy5n0fj2bmbXEQYoCieE_JZ0obcdZtN3GEUNWEqoo0ohbsVXFUE8YqQTg_eHQ-LE5y3hBcjCvO6zfFYVNLxeuWHBXjymQo-5jK65hHP5mhDHPKUE2xGs3kIUxlwj2WA6x9HnbHUPpQ_poBAn4Hd1pezHlKZvDm9IGSv5QmlLHLkG7uPAjO0-xu3xWvewzDyX4_Lv58-_p79aO6-vn9cnVxVXW8UVNFe9aInkgGFiiVLXGCWauMIED7vlWdbRWX-AqiWEf7FkhNHfStlJxb4rrmuLhcuC6ajR6T35p0q6Px-u4iprU2afJ2AO1UI4mj0JjGsM510grKHTD8P-2I65F1vrDGuduCs1gUfO4T6NNI8Nd6HW90y1rBZI2AT3tAin9nyJPe-mxhwPJBnLOuGWslq1vFUPrxmXQT54TlQ5UQDLsqJUXVh8cZPaRy31gUqEVgU8w5Qa8ttmXXCEzQD5oSvZsjvZ8jvZsjvcwReptn3nv8y66zxYXB_zm_5PgHkv3elg |
| CitedBy_id | crossref_primary_10_1016_j_profnurs_2021_12_002 crossref_primary_10_1136_bmj_2024_079987 crossref_primary_10_3390_ijerph18020605 crossref_primary_10_4103_jehp_jehp_972_22 crossref_primary_10_1016_j_ijnurstu_2025_105178 crossref_primary_10_4103_jehp_jehp_1398_22 crossref_primary_10_11124_JBIES_21_00083 crossref_primary_10_3390_brainsci12111481 crossref_primary_10_1136_bmjopen_2021_052899 crossref_primary_10_1136_bmjqs_2022_015291 crossref_primary_10_1016_j_gerinurse_2025_01_008 crossref_primary_10_1016_j_ajic_2020_12_002 crossref_primary_10_1177_08980101211065600 crossref_primary_10_1016_j_outlook_2021_09_007 crossref_primary_10_3390_ijerph21101309 crossref_primary_10_1111_jnu_70013 crossref_primary_10_1186_s12912_025_03292_6 crossref_primary_10_1016_j_ijnurstu_2024_104777 crossref_primary_10_1097_NCQ_0000000000000879 crossref_primary_10_1111_jocn_16835 crossref_primary_10_3389_frhs_2024_1448913 crossref_primary_10_1001_jamanetworkopen_2024_4121 crossref_primary_10_3390_systems10050187 crossref_primary_10_1371_journal_pone_0303255 crossref_primary_10_1111_nhs_12924 crossref_primary_10_1155_2023_5599128 crossref_primary_10_1002_nur_70013 crossref_primary_10_1136_bmjopen_2025_099358 crossref_primary_10_1097_01_NUMA_0000805032_15402_b3 crossref_primary_10_1016_j_soncn_2024_151583 crossref_primary_10_1016_j_colegn_2023_09_003 crossref_primary_10_7748_ns_2025_e12488 crossref_primary_10_3389_fpubh_2024_1383735 crossref_primary_10_1016_j_jopan_2023_11_015 crossref_primary_10_1080_10376178_2024_2318361 crossref_primary_10_1071_AH22283 crossref_primary_10_1177_15271544251317506 crossref_primary_10_1016_j_ijnurstu_2023_104604 crossref_primary_10_1016_j_auec_2025_01_003 crossref_primary_10_7759_cureus_86089 |
| Cites_doi | 10.1186/1472-6963-8-12 10.1097/MLR.0b013e3182330b6e 10.1016/j.jclinepi.2004.03.012 10.1016/S0140-6736(13)62631-8 10.1016/j.apnr.2009.12.004 10.1136/bmj.e1717 10.1097/NCQ.0000000000000334 10.1016/j.ijnurstu.2017.08.004 10.1111/j.1475-6773.2010.01114.x 10.1001/jama.2014.15273 10.1002/nur.21503 10.1016/0895-4356(94)90129-5 10.1097/HMR.0000000000000070 10.1097/MLR.0000000000001002 10.1016/j.ijnurstu.2016.06.005 10.1177/1077558712449056 10.1001/jamasurg.2015.4908 10.1097/MLR.0b013e3182726cc5 10.1001/jama.298.9.975 10.1056/NEJMsa1001025 10.1001/jama.288.16.1987 10.1016/j.ijnurstu.2012.07.014 10.1016/j.ijnurstu.2011.10.001 10.1093/aje/kwq433 10.2307/2092683 10.1097/01.mlr.0000182534.19832.83 10.1377/hlthaff.2010.0100 10.1097/01.mlr.0000109126.50398.5a 10.1093/intqhc/mzw007 10.1097/MLR.0000000000000355 10.1136/bmjqs-2018-008043 10.1186/s12913-019-4688-7 10.1111/j.1547-5069.1998.tb01234.x 10.1377/hlthaff.2018.0711 10.1002/9781394260645 |
| ContentType | Journal Article |
| Copyright | Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2020 Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2020 |
| Copyright_xml | – notice: Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. – notice: 2020 Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2020 |
| DBID | 9YT ACMMV AAYXX CITATION CGR CUY CVF ECM EIF NPM 3V. 7RV 7X7 7XB 88E 88G 8FI 8FJ 8FK ABUWG AFKRA AZQEC BENPR BTHHO CCPQU DWQXO FYUFA GHDGH GNUQQ K9- K9. KB0 M0R M0S M1P M2M NAPCQ PHGZM PHGZT PIMPY PJZUB PKEHL PPXIY PQEST PQQKQ PQUKI PRINS PSYQQ Q9U 7X8 5PM DOA |
| DOI | 10.1136/bmjopen-2019-036264 |
| DatabaseName | BMJ Open Access Journals BMJ Journals:Open Access CrossRef Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed ProQuest Central (Corporate) Nursing & Allied Health Database Health & Medical Collection ProQuest Central (purchase pre-March 2016) Medical Database (Alumni Edition) Psychology Database (Alumni) Hospital Premium Collection Hospital Premium Collection (Alumni Edition) ProQuest Central (Alumni) (purchase pre-March 2016) ProQuest Central (Alumni) ProQuest Central UK/Ireland ProQuest Central Essentials ProQuest Central BMJ Journals ProQuest One Community College ProQuest Central Health Research Premium Collection Health Research Premium Collection (Alumni) ProQuest Central Student Consumer Health Database (Alumni Edition) ProQuest Health & Medical Complete (Alumni) Nursing & Allied Health Database (Alumni Edition) Consumer Health Database Health & Medical Collection (Alumni Edition) PML(ProQuest Medical Library) Psychology Database Nursing & Allied Health Premium ProQuest Central Premium ProQuest One Academic (New) Publicly Available Content Database (subscription) ProQuest Health & Medical Research Collection ProQuest One Academic Middle East (New) One Health & Nursing ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic (retired) ProQuest One Academic UKI Edition ProQuest Central China ProQuest One Psychology ProQuest Central Basic MEDLINE - Academic PubMed Central (Full Participant titles) Directory of Open Access Journals |
| DatabaseTitle | CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) Publicly Available Content Database ProQuest One Psychology ProQuest Central Student ProQuest One Academic Middle East (New) ProQuest Central Essentials ProQuest Health & Medical Complete (Alumni) ProQuest Central (Alumni Edition) ProQuest One Community College ProQuest One Health & Nursing ProQuest Family Health (Alumni Edition) ProQuest Central China ProQuest Central ProQuest Health & Medical Research Collection Health Research Premium Collection Health and Medicine Complete (Alumni Edition) ProQuest Central Korea Health & Medical Research Collection ProQuest Central (New) ProQuest Medical Library (Alumni) ProQuest Central Basic ProQuest Family Health ProQuest One Academic Eastern Edition ProQuest Nursing & Allied Health Source ProQuest Hospital Collection Health Research Premium Collection (Alumni) ProQuest Psychology Journals (Alumni) ProQuest Hospital Collection (Alumni) Nursing & Allied Health Premium ProQuest Health & Medical Complete ProQuest Medical Library ProQuest Psychology Journals ProQuest One Academic UKI Edition BMJ Journals ProQuest Nursing & Allied Health Source (Alumni) ProQuest One Academic ProQuest One Academic (New) ProQuest Central (Alumni) MEDLINE - Academic |
| DatabaseTitleList | Publicly Available Content Database MEDLINE - Academic MEDLINE |
| Database_xml | – sequence: 1 dbid: DOA name: DOAJ Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website – sequence: 2 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 3 dbid: 7RV name: Nursing & Allied Health Database url: https://search.proquest.com/nahs sourceTypes: Aggregation Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine Nursing |
| EISSN | 2044-6055 |
| ExternalDocumentID | oai_doaj_org_article_d9380d1e3a3a4bdb8c615de46f01b0df PMC7476482 32895270 10_1136_bmjopen_2019_036264 bmjopen |
| Genre | Research Support, Non-U.S. Gov't Journal Article Observational Study Research Support, N.I.H., Extramural |
| GeographicLocations | Australia Queensland California Queensland Australia United States--US |
| GeographicLocations_xml | – name: Australia – name: Queensland – name: California – name: Queensland Australia – name: United States--US |
| GrantInformation_xml | – fundername: Department of Health, Queensland grantid: project NM006239/RP731123 funderid: http://dx.doi.org/10.13039/100010230 – fundername: National Institute of Nursing Research grantid: R01NR014855 funderid: http://dx.doi.org/10.13039/100000056 – fundername: NINR NIH HHS grantid: R01 NR014855 – fundername: ; grantid: project NM006239/RP731123 – fundername: ; grantid: R01NR014855 |
| GroupedDBID | --- 4.4 53G 5VS 7RV 7X7 7~R 88E 8FI 8FJ 9YT ABUWG ACGFS ACMMV ADBBV AENEX AFKRA ALIPV ALMA_UNASSIGNED_HOLDINGS AOIJS AZQEC BAWUL BCNDV BENPR BKNYI BPHCQ BTFSW BTHHO CCPQU DIK DWQXO EBS FYUFA GNUQQ GROUPED_DOAJ GX1 H13 HMCUK HYE HZ~ K9- KQ8 M0R M1P M2M M48 M~E NAPCQ O9- OK1 PGMZT PHGZT PIMPY PQQKQ PROAC PSQYO PSYQQ RHI RMJ RPM UKHRP AAYXX ADRAZ AFFHD BVXVI CITATION EJD PHGZM PJZUB PPXIY CGR CUY CVF ECM EIF NPM 3V. 7XB 8FK K9. PKEHL PQEST PQUKI PRINS Q9U 7X8 5PM |
| ID | FETCH-LOGICAL-b539t-1f436f084ece11870d64cc9a60e1ff79bc7958895094b1f7e021def78855c0db3 |
| IEDL.DBID | 7X7 |
| ISICitedReferencesCount | 40 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000570963700045&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 2044-6055 |
| IngestDate | Tue Oct 14 19:05:12 EDT 2025 Tue Nov 04 01:59:59 EST 2025 Sun Nov 09 11:14:02 EST 2025 Tue Oct 07 07:37:14 EDT 2025 Mon Jul 21 05:38:48 EDT 2025 Sat Nov 29 04:17:38 EST 2025 Tue Nov 18 20:52:14 EST 2025 Thu Apr 24 22:49:34 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 9 |
| Keywords | international health services quality in health care health policy |
| Language | English |
| License | This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-b539t-1f436f084ece11870d64cc9a60e1ff79bc7958895094b1f7e021def78855c0db3 |
| Notes | Original research ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 ObjectType-Undefined-3 |
| ORCID | 0000-0002-1263-0697 0000-0001-8946-8504 |
| OpenAccessLink | https://www.proquest.com/docview/2664204881?pq-origsite=%requestingapplication% |
| PMID | 32895270 |
| PQID | 2664204881 |
| PQPubID | 2040975 |
| ParticipantIDs | doaj_primary_oai_doaj_org_article_d9380d1e3a3a4bdb8c615de46f01b0df pubmedcentral_primary_oai_pubmedcentral_nih_gov_7476482 proquest_miscellaneous_2447842794 proquest_journals_2664204881 pubmed_primary_32895270 crossref_citationtrail_10_1136_bmjopen_2019_036264 crossref_primary_10_1136_bmjopen_2019_036264 bmj_journals_10_1136_bmjopen_2019_036264 |
| PublicationCentury | 2000 |
| PublicationDate | 2020-09-06 |
| PublicationDateYYYYMMDD | 2020-09-06 |
| PublicationDate_xml | – month: 09 year: 2020 text: 2020-09-06 day: 06 |
| PublicationDecade | 2020 |
| PublicationPlace | England |
| PublicationPlace_xml | – name: England – name: London – name: BMA House, Tavistock Square, London, WC1H 9JR |
| PublicationSeriesTitle | Original research |
| PublicationTitle | BMJ open |
| PublicationTitleAbbrev | BMJ Open |
| PublicationTitleAlternate | BMJ Open |
| PublicationYear | 2020 |
| Publisher | British Medical Journal Publishing Group BMJ Publishing Group LTD BMJ Publishing Group |
| Publisher_xml | – name: British Medical Journal Publishing Group – name: BMJ Publishing Group LTD – name: BMJ Publishing Group |
| References | Aiken, Sermeus, Van den Heede (R13) 2012; 344 Smeds-Alenius, Tishelman, Lindqvist (R26) 2016; 61 Vahey, Aiken, Sloane (R34) 2004; 42 Sloane, Smith, McHugh (R24) 2018; 56 Volpp, Rosen, Rosenbaum (R18) 2007; 298 Lasater, Mchugh (R6) 2016; 28 Aiken, Hage (R15) 1968; 33 Griffiths, Maruotti, Recio Saucedo (R7) 2019; 28 Aiken, Cimiotti, Sloane (R37) 2011; 49 Charlson, Szatrowski, Peterson (R19) 1994; 47 Patel, Volpp, Small (R17) 2014; 312 Kutney-Lee, Stimpfel, Sloane, Quinn, Witkoski Stimpfel (R38) 2015; 53 Haegdorens, Van Bogaert, De Meester (R1) 2019; 19 Hayes, O’Brien-Pallas, Duffield (R31) 2012; 49 Aiken, Sloane, Bruyneel (R3) 2014; 383 Brooks Carthon, Hatfield, Plover (R8) 2019; 34 Li, Evans, Faris (R20) 2008; 8 McHugh, Kelly, Smith (R39) 2013; 51 Quan, Sundararajan, Halfon (R22) 2005; 43 Aiken, Clarke, Sloane (R2) 2002; 288 Quan, Li, Couris (R21) 2011; 173 Silber, Rosenbaum, McHugh (R10) 2016; 151 Kutney-Lee, Wu, Sloane (R33) 2013; 50 Sundararajan, Henderson, Perry (R23) 2004; 57 McHugh, Kutney-Lee, Cimiotti (R27) 2011; 30 Aiken, Sloane, Barnes (R35) 2018; 37 McHugh, Stimpfel (R25) 2012; 35 Aiken, Sloane, Cimiotti (R4) 2010; 45 Duffield, Diers, O’Brien-Pallas (R5) 2011; 24 Ball, Bruyneel, Aiken (R40) 2018; 78 McHugh, Aiken, Eckenhoff (R36) 2016; 41 Needleman, Buerhaus, Pankratz (R9) 2011; 364 Mitchell, Ferketich, Jennings (R14) 1998; 30 Gilmartin (R30) 2013; 70 Sloane (2020090700402009000_10.9.e036264.24) 2018; 56 Aiken (2020090700402009000_10.9.e036264.35) 2018; 37 2020090700402009000_10.9.e036264.30 2020090700402009000_10.9.e036264.16 2020090700402009000_10.9.e036264.38 2020090700402009000_10.9.e036264.15 2020090700402009000_10.9.e036264.37 2020090700402009000_10.9.e036264.14 2020090700402009000_10.9.e036264.13 2020090700402009000_10.9.e036264.12 2020090700402009000_10.9.e036264.34 2020090700402009000_10.9.e036264.11 2020090700402009000_10.9.e036264.33 2020090700402009000_10.9.e036264.32 2020090700402009000_10.9.e036264.31 2020090700402009000_10.9.e036264.19 2020090700402009000_10.9.e036264.18 2020090700402009000_10.9.e036264.17 McHugh (2020090700402009000_10.9.e036264.36) 2016; 41 2020090700402009000_10.9.e036264.39 2020090700402009000_10.9.e036264.40 Silber (2020090700402009000_10.9.e036264.10) 2016; 151 Haegdorens (2020090700402009000_10.9.e036264.1) 2019; 19 2020090700402009000_10.9.e036264.27 Smeds-Alenius (2020090700402009000_10.9.e036264.26) 2016; 61 2020090700402009000_10.9.e036264.25 2020090700402009000_10.9.e036264.23 2020090700402009000_10.9.e036264.22 2020090700402009000_10.9.e036264.21 2020090700402009000_10.9.e036264.20 2020090700402009000_10.9.e036264.9 2020090700402009000_10.9.e036264.6 2020090700402009000_10.9.e036264.7 2020090700402009000_10.9.e036264.4 2020090700402009000_10.9.e036264.5 Brooks Carthon (2020090700402009000_10.9.e036264.8) 2019; 34 2020090700402009000_10.9.e036264.2 2020090700402009000_10.9.e036264.29 2020090700402009000_10.9.e036264.3 2020090700402009000_10.9.e036264.28 |
| References_xml | – volume: 8 start-page: 12 year: 2008 ident: R20 article-title: Risk adjustment performance of Charlson and Elixhauser comorbidities in ICD-9 and ICD-10 administrative databases publication-title: BMC Health Serv Res doi: 10.1186/1472-6963-8-12 – volume: 49 start-page: 1047 year: 2011 ident: R37 article-title: Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments publication-title: Med Care doi: 10.1097/MLR.0b013e3182330b6e – volume: 57 start-page: 1288 year: 2004 ident: R23 article-title: New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality publication-title: J Clin Epidemiol doi: 10.1016/j.jclinepi.2004.03.012 – volume: 383 start-page: 1824 year: 2014 ident: R3 article-title: Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study publication-title: Lancet doi: 10.1016/S0140-6736(13)62631-8 – volume: 24 start-page: 244 year: 2011 ident: R5 article-title: Nursing staffing, nursing workload, the work environment and patient outcomes publication-title: Appl Nurs Res doi: 10.1016/j.apnr.2009.12.004 – volume: 344 year: 2012 ident: R13 article-title: Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States publication-title: BMJ doi: 10.1136/bmj.e1717 – volume: 30 start-page: 43 year: 1998 ident: R14 article-title: American Academy of nursing expert panel on quality health care. quality health outcomes model publication-title: Image J Nurs Sch – volume: 34 start-page: 40 year: 2019 ident: R8 article-title: Association of nurse engagement and nurse staffing on patient safety publication-title: J Nurs Care Qual doi: 10.1097/NCQ.0000000000000334 – volume: 78 start-page: 10 year: 2018 ident: R40 article-title: Post-operative mortality, missed care and nurse staffing in nine countries: a cross-sectional study publication-title: Int J Nurs Stud doi: 10.1016/j.ijnurstu.2017.08.004 – volume: 45 start-page: 904 year: 2010 ident: R4 article-title: Implications of the California nurse staffing mandate for other states publication-title: Health Serv Res doi: 10.1111/j.1475-6773.2010.01114.x – volume: 37 start-page: 1744 year: 2018 ident: R35 article-title: Nurses’ and patients’ appraisals show patient safety in hospitals is still deficient and recommended measures not implemented publication-title: Health Aff – volume: 312 start-page: 2364 year: 2014 ident: R17 article-title: Association of the 2011 ACGME resident duty hour reforms with mortality and readmissions among hospitalized Medicare patients publication-title: JAMA doi: 10.1001/jama.2014.15273 – volume: 35 start-page: 566 year: 2012 ident: R25 article-title: Nurse reported quality of care: a measure of hospital quality publication-title: Res Nurs Health doi: 10.1002/nur.21503 – volume: 47 start-page: 1245 year: 1994 ident: R19 article-title: Validation of a combined comorbidity index publication-title: J Clin Epidemiol doi: 10.1016/0895-4356(94)90129-5 – volume: 41 start-page: 178 year: 2016 ident: R36 article-title: Achieving Kaiser Permanente quality publication-title: Health Care Manage Rev doi: 10.1097/HMR.0000000000000070 – volume: 56 start-page: 1001 year: 2018 ident: R24 article-title: Effect of changes in hospital nursing resources on improvements in patient safety and quality of care: a panel study publication-title: Med Care doi: 10.1097/MLR.0000000000001002 – volume: 61 start-page: 117 year: 2016 ident: R26 article-title: RN assessments of excellent quality of care and patient safety are associated with significantly lower odds of 30-day inpatient mortality: a national cross-sectional study of acute-care hospitals publication-title: Int J Nurs Stud doi: 10.1016/j.ijnurstu.2016.06.005 – volume: 70 start-page: 3 year: 2013 ident: R30 article-title: Thirty years of nursing turnover research: looking back to move forward publication-title: Med Care Res Rev doi: 10.1177/1077558712449056 – volume: 151 start-page: 527 year: 2016 ident: R10 article-title: Comparison of the value of nursing work environments in hospitals across different levels of patient risk publication-title: JAMA Surg doi: 10.1001/jamasurg.2015.4908 – volume: 51 start-page: 382 year: 2013 ident: R39 article-title: Lower mortality in magnet hospitals publication-title: Med Care doi: 10.1097/MLR.0b013e3182726cc5 – volume: 298 start-page: 975 year: 2007 ident: R18 article-title: Mortality among hospitalized Medicare beneficiaries in the first 2 years following ACGME resident duty hour reform publication-title: JAMA doi: 10.1001/jama.298.9.975 – volume: 364 start-page: 1037 year: 2011 ident: R9 article-title: Nurse staffing and inpatient hospital mortality publication-title: N Engl J Med doi: 10.1056/NEJMsa1001025 – volume: 288 start-page: 1987 year: 2002 ident: R2 article-title: Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction publication-title: JAMA doi: 10.1001/jama.288.16.1987 – volume: 50 start-page: 195 year: 2013 ident: R33 article-title: Changes in hospital nurse work environments and nurse job outcomes: an analysis of panel data publication-title: Int J Nurs Stud doi: 10.1016/j.ijnurstu.2012.07.014 – volume: 49 start-page: 887 year: 2012 ident: R31 article-title: Nurse turnover: a literature review - an update publication-title: Int J Nurs Stud doi: 10.1016/j.ijnurstu.2011.10.001 – volume: 173 start-page: 676 year: 2011 ident: R21 article-title: Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries publication-title: Am J Epidemiol doi: 10.1093/aje/kwq433 – volume: 33 start-page: 912 year: 1968 ident: R15 article-title: Organizational interdependence and Intra-Organizational structure publication-title: Am Sociol Rev doi: 10.2307/2092683 – volume: 43 start-page: 1130 year: 2005 ident: R22 article-title: Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data publication-title: Med Care doi: 10.1097/01.mlr.0000182534.19832.83 – volume: 30 start-page: 202 year: 2011 ident: R27 article-title: Nurses’ widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care publication-title: Health Aff doi: 10.1377/hlthaff.2010.0100 – volume: 42 start-page: II57 year: 2004 ident: R34 article-title: Nurse burnout and patient satisfaction publication-title: Med Care doi: 10.1097/01.mlr.0000109126.50398.5a – volume: 28 start-page: 253 year: 2016 ident: R6 article-title: Nurse staffing and the work environment linked to readmissions among older adults following elective total hip and knee replacement publication-title: Int J Qual Health Care doi: 10.1093/intqhc/mzw007 – volume: 53 start-page: 550 year: 2015 ident: R38 article-title: Changes in patient and nurse outcomes associated with Magnet hospital recognition publication-title: Med Care doi: 10.1097/MLR.0000000000000355 – volume: 28 start-page: 609 year: 2019 ident: R7 article-title: Nurse staffing, nursing assistants and hospital mortality: retrospective longitudinal cohort study publication-title: BMJ Qual Saf doi: 10.1136/bmjqs-2018-008043 – volume: 19 start-page: 1 year: 2019 ident: R1 article-title: The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multicentre study publication-title: BMC Health Serv Res doi: 10.1186/s12913-019-4688-7 – ident: 2020090700402009000_10.9.e036264.12 – ident: 2020090700402009000_10.9.e036264.37 doi: 10.1097/MLR.0b013e3182330b6e – volume: 19 start-page: 1 year: 2019 ident: 2020090700402009000_10.9.e036264.1 article-title: The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multicentre study publication-title: BMC Health Serv Res doi: 10.1186/s12913-019-4688-7 – ident: 2020090700402009000_10.9.e036264.4 doi: 10.1111/j.1475-6773.2010.01114.x – ident: 2020090700402009000_10.9.e036264.14 doi: 10.1111/j.1547-5069.1998.tb01234.x – ident: 2020090700402009000_10.9.e036264.33 doi: 10.1016/j.ijnurstu.2012.07.014 – ident: 2020090700402009000_10.9.e036264.23 doi: 10.1016/j.jclinepi.2004.03.012 – ident: 2020090700402009000_10.9.e036264.29 – ident: 2020090700402009000_10.9.e036264.17 doi: 10.1001/jama.2014.15273 – ident: 2020090700402009000_10.9.e036264.27 doi: 10.1377/hlthaff.2010.0100 – ident: 2020090700402009000_10.9.e036264.20 doi: 10.1186/1472-6963-8-12 – volume: 34 start-page: 40 year: 2019 ident: 2020090700402009000_10.9.e036264.8 article-title: Association of nurse engagement and nurse staffing on patient safety publication-title: J Nurs Care Qual doi: 10.1097/NCQ.0000000000000334 – ident: 2020090700402009000_10.9.e036264.7 doi: 10.1136/bmjqs-2018-008043 – ident: 2020090700402009000_10.9.e036264.19 doi: 10.1016/0895-4356(94)90129-5 – ident: 2020090700402009000_10.9.e036264.32 – volume: 37 start-page: 1744 year: 2018 ident: 2020090700402009000_10.9.e036264.35 article-title: Nurses’ and patients’ appraisals show patient safety in hospitals is still deficient and recommended measures not implemented publication-title: Health Aff doi: 10.1377/hlthaff.2018.0711 – ident: 2020090700402009000_10.9.e036264.39 doi: 10.1097/MLR.0b013e3182726cc5 – ident: 2020090700402009000_10.9.e036264.40 doi: 10.1016/j.ijnurstu.2017.08.004 – ident: 2020090700402009000_10.9.e036264.5 doi: 10.1016/j.apnr.2009.12.004 – ident: 2020090700402009000_10.9.e036264.25 doi: 10.1002/nur.21503 – ident: 2020090700402009000_10.9.e036264.34 doi: 10.1097/01.mlr.0000109126.50398.5a – ident: 2020090700402009000_10.9.e036264.38 doi: 10.1097/MLR.0000000000000355 – ident: 2020090700402009000_10.9.e036264.11 – ident: 2020090700402009000_10.9.e036264.9 doi: 10.1056/NEJMsa1001025 – volume: 61 start-page: 117 year: 2016 ident: 2020090700402009000_10.9.e036264.26 article-title: RN assessments of excellent quality of care and patient safety are associated with significantly lower odds of 30-day inpatient mortality: a national cross-sectional study of acute-care hospitals publication-title: Int J Nurs Stud doi: 10.1016/j.ijnurstu.2016.06.005 – ident: 2020090700402009000_10.9.e036264.6 doi: 10.1093/intqhc/mzw007 – ident: 2020090700402009000_10.9.e036264.3 doi: 10.1016/S0140-6736(13)62631-8 – ident: 2020090700402009000_10.9.e036264.13 doi: 10.1136/bmj.e1717 – ident: 2020090700402009000_10.9.e036264.28 – ident: 2020090700402009000_10.9.e036264.2 doi: 10.1001/jama.288.16.1987 – volume: 56 start-page: 1001 year: 2018 ident: 2020090700402009000_10.9.e036264.24 article-title: Effect of changes in hospital nursing resources on improvements in patient safety and quality of care: a panel study publication-title: Med Care doi: 10.1097/MLR.0000000000001002 – ident: 2020090700402009000_10.9.e036264.30 doi: 10.1177/1077558712449056 – ident: 2020090700402009000_10.9.e036264.21 doi: 10.1093/aje/kwq433 – volume: 151 start-page: 527 year: 2016 ident: 2020090700402009000_10.9.e036264.10 article-title: Comparison of the value of nursing work environments in hospitals across different levels of patient risk publication-title: JAMA Surg doi: 10.1001/jamasurg.2015.4908 – ident: 2020090700402009000_10.9.e036264.22 doi: 10.1097/01.mlr.0000182534.19832.83 – ident: 2020090700402009000_10.9.e036264.18 doi: 10.1001/jama.298.9.975 – volume: 41 start-page: 178 year: 2016 ident: 2020090700402009000_10.9.e036264.36 article-title: Achieving Kaiser Permanente quality publication-title: Health Care Manage Rev doi: 10.1097/HMR.0000000000000070 – ident: 2020090700402009000_10.9.e036264.15 doi: 10.2307/2092683 – ident: 2020090700402009000_10.9.e036264.31 doi: 10.1016/j.ijnurstu.2011.10.001 – ident: 2020090700402009000_10.9.e036264.16 doi: 10.1002/9781394260645 |
| SSID | ssj0000459552 |
| Score | 2.4397643 |
| Snippet | ObjectivesTo determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio... To determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation... Objectives To determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio... |
| SourceID | doaj pubmedcentral proquest pubmed crossref bmj |
| SourceType | Open Website Open Access Repository Aggregation Database Index Database Enrichment Source Publisher |
| StartPage | e036264 |
| SubjectTerms | Australia Burnout, Professional - epidemiology Clinical outcomes Cross-Sectional Studies health policy Hospitals Humans international health services Job Satisfaction Legislation Mortality Nurses Nursing Nursing Staff, Hospital Observational studies Patient safety Personnel Staffing and Scheduling quality in health care Quality of Health Care Queensland Ratios Workforce planning Workloads |
| SummonAdditionalLinks | – databaseName: BMJ Journals dbid: RMJ link: http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwEB61BapeeJRSAgUZiQOHTZvEThxzg4oKIVoBAqm3KH61i9qk2t3y-5lxvIFFqEKcIsVjKx6P43n5G4CXWihbWNGmjvJ1hFN5qrlsUyU9N1Yo3rYBMv-jPDmpT0_VpzXIl3dh9OV3Khu1j8_hRgNhNHUEKn-gDlwATxH75Jleh1tk2lAW15fjD6NbBTUUVYY6O0UmRIrKehmxhnJeLUdH0aCrO2GwLdjkaHSUBZUrXkeClQMq4Pj_Tfn8M4fyt0Pp6N5_TOc-3I0aKHsziMwDWHPdNmwexxj7NtyJDoSHcHWIRxxDrZadx-oiLOR8pIs-jXisLAgQu3Bn0_mQVcemHfscrGPKmZyw0ZkyGUeZv2Ztx3o9OoRx4ABzuwPfjt59PXyfxgoNqS65WqS5F7zyWS2ccVS3PLOVMEa1VeZy76XSRqqyRu6iEalzLx1qFNZ5NLvL0mRW80ew0fWdewyMy6L1lSm8okCgLJUXudVKlsaWBAOWwCtkYhN32LwJxguvmsjhhpa0GRiaQLFcwcZEpHMquHFxc6fJ2OlqAPq4mfwticZISijd4UU_O2vipm-s4nVmc8db3gptdW1Qf7ROIMtynVmfwN5SsH5NDDUmQWjKdZ7Ai7EZNz1FctrO9ddII4SsRYH_0gR2Bzkcv2QpzQnIFQld-dTVlm56HoDF0bSsRF08-XdWP4WtghwQFGGr9mBjMbt2z-C2-bGYzmfPw9b8CfXQN9Y priority: 102 providerName: BMJ Publishing Group Ltd – databaseName: Directory of Open Access Journals dbid: DOA link: http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV3NaxUxEB-kFPEi9XttlQgePLylm02ySbzVYvGgRUGhtyWf9pW6r_S99u9vJpuu74nUi9d8kWQmmZnM5DcAby3XvvXc1AHjdXjQtLZMmlrLyJznmhmTIfM_y-NjdXKiv66l-sKYsBEeeNy4fa-ZajwNzDDDrbfKJRnsA-9iQ23jI96-jdRrxlS-g7nQQrQFZoiybt_-OsN8VIkr8NcOgrDwJE5S6YZAyrj9f1M2_4yZXBNCRzvwsGiP5GCc9SO4F4bHcP9L8Y8_gYvDJJRI0kPJackHQnKURr1a1AVBlWSSk_Pwc74c4-DIfCDfsj2LUY4zMj1_zKZRlu-JGcjCTk-4aeAMTPsUfhx9_H74qS45FWormF7VNHKWtk7x4AJmGm98x53TpmsCjVFq66QWSmnE1bM0ypB0AB9iMpSFcI237BlsDYshvADCZGti59qo0XUnhY6cequlcF4gcFcF79L29uVMLPtsbrCuL5TokRL9SIkK2lsa9K5gk2OKjPO7O82mThcjNMfdzT8gcaemiKudCxK39YXb-n9xWwV7t6zxe2FJx-GIf6xoBW-m6nRM0fdihrC4Sm04l4q36far4PnISdNMWDJ6RSubCuQGj21MdbNmmJ9mKPBkDHZctS__x9p24UGLjwnoLev2YGt1eRVewba7Xs2Xl6_z-boBuNcsoA priority: 102 providerName: Directory of Open Access Journals |
| Title | Case for hospital nurse-to-patient ratio legislation in Queensland, Australia, hospitals: an observational study |
| URI | https://bmjopen.bmj.com/content/10/9/e036264.full https://www.ncbi.nlm.nih.gov/pubmed/32895270 https://www.proquest.com/docview/2664204881 https://www.proquest.com/docview/2447842794 https://pubmed.ncbi.nlm.nih.gov/PMC7476482 https://doaj.org/article/d9380d1e3a3a4bdb8c615de46f01b0df |
| Volume | 10 |
| WOSCitedRecordID | wos000570963700045&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| journalDatabaseRights | – providerCode: PRVADZ databaseName: BMJ Journals customDbUrl: eissn: 2044-6055 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000459552 issn: 2044-6055 databaseCode: RMJ dateStart: 20110101 isFulltext: true titleUrlDefault: http://www.bmj.com/thebmj providerName: BMJ Publishing Group Ltd – providerCode: PRVAON databaseName: DOAJ Directory of Open Access Journals customDbUrl: eissn: 2044-6055 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000459552 issn: 2044-6055 databaseCode: DOA dateStart: 20110101 isFulltext: true titleUrlDefault: https://www.doaj.org/ providerName: Directory of Open Access Journals – providerCode: PRVHPJ databaseName: ROAD: Directory of Open Access Scholarly Resources customDbUrl: eissn: 2044-6055 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000459552 issn: 2044-6055 databaseCode: M~E dateStart: 20110101 isFulltext: true titleUrlDefault: https://road.issn.org providerName: ISSN International Centre – providerCode: PRVPQU databaseName: AUTh Library subscriptions: ProQuest Central customDbUrl: eissn: 2044-6055 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000459552 issn: 2044-6055 databaseCode: BENPR dateStart: 20110101 isFulltext: true titleUrlDefault: https://www.proquest.com/central providerName: ProQuest – providerCode: PRVPQU databaseName: Consumer Health Database customDbUrl: eissn: 2044-6055 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000459552 issn: 2044-6055 databaseCode: M0R dateStart: 20110101 isFulltext: true titleUrlDefault: https://search.proquest.com/familyhealth providerName: ProQuest – providerCode: PRVPQU databaseName: Health & Medical Collection customDbUrl: eissn: 2044-6055 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000459552 issn: 2044-6055 databaseCode: 7X7 dateStart: 20110101 isFulltext: true titleUrlDefault: https://search.proquest.com/healthcomplete providerName: ProQuest – providerCode: PRVPQU databaseName: Nursing & Allied Health Database customDbUrl: eissn: 2044-6055 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000459552 issn: 2044-6055 databaseCode: 7RV dateStart: 20110101 isFulltext: true titleUrlDefault: https://search.proquest.com/nahs providerName: ProQuest – providerCode: PRVPQU databaseName: Psychology Database customDbUrl: eissn: 2044-6055 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000459552 issn: 2044-6055 databaseCode: M2M dateStart: 20110101 isFulltext: true titleUrlDefault: https://www.proquest.com/psychology providerName: ProQuest – providerCode: PRVPQU databaseName: Publicly Available Content Database (subscription) customDbUrl: eissn: 2044-6055 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0000459552 issn: 2044-6055 databaseCode: PIMPY dateStart: 20110101 isFulltext: true titleUrlDefault: http://search.proquest.com/publiccontent providerName: ProQuest |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1Lj9MwELZgFyEuvB-BpTISBw6NNomdOOaC2NWuAJGqVIDKKYpfu0VLUtouv58Z181ShHrhErWxEzmZGc8z3xDyUnFpMsOb2GK9DrcyjRUTTSyFY9pwyZrGQ-Z_FKNROZ3KcQi4LUNZ5WZP9Bu16TTGyA9BkXAEmS3TN_OfMXaNwuxqaKFxnexj22zkczEVfYwFzBWZ51kAG0pZcah-fMeuVMAb-O0OQrFwUCpwdkstefT-f5mcf1dO_qGKTu_870PcJbeDEUrfrrnmHrlm2_vkZhXS7A_I_Bh0GwVzlp6HtiLUF3vEqy4OQKzUcw69sGez5bqcjs5a-sm7xVgsOaR9FGXY32X5mjYt7VQfCYYbe3zbh-TL6cnn43dxaM0Qq5zJVZw6zgqXlNxqi28-MQXXWjZFYlPnhFRayLwsJcLzqdQJC6aEsQ787TzXiVHsEdlru9Y-IZSJrHGFzpzEDKDIpeOpUVLk2uSI_xWRV0CfOojWsvZeCyvqQMoaSVmvSRmRbEPEWgeIc-y0cbH7omF_0XyN8LF7-hFyRz8V4bn9iW5xVgdpr41kZWJSyxrWcGVUqcFwNJbDK0tVYlxEDjb8cfVgV8wRkRf9MEg7pnCa1naXMIdzUfIMNtGIPF6zYr8SBr5znokkImKLSbeWuj3Szs49ojj4lAUvs6e7l_WM3Mow2oDptOKA7K0Wl_Y5uaF_rWbLxQBEb_J14AXQH8sB2T86GY0nAx_ngGOV4O8qq2Bk_L4af4N_k-rDb6IaQpA |
| linkProvider | ProQuest |
| linkToHtml | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V1bb9MwFD4aHQJeuF8CA4wEEg-NlthOHCMhBINp1dqqSEPankJ824pGUpoOxJ_iN2InbkYR6tseeE0cy3G-c_XJdwCeC8oVVrQItavXoZrHoSCsCDkzRCrKSVE0lPlDNh5nh4d8sgG_lv_CuLLKpU5sFLWqpMuRb1tDQh3JbBa_mX0LXdcod7q6bKHRwmJf__xhQ7b69eC9_b4vMN79cLCzF_quAqFICF-EsaEkNVFGtdSu13akUiolL9JIx8YwLiTjSZZxxywnYsO0tYJKGxsqJomMlCB23kuwSR3Ye7A5GYwmR11WxzpIPEmwpzeKSbotvn5xfbAsGt3fQo78hVozZq-uGMKmX8C_nNy_azX_MH67N_63bbsJ172bjd62cnELNnR5G66MfCHBHZjtWOuNrMOOTnzjFNSUs4SLKvRUs6iRDXSqj6d1WzCIpiX62AT-rhy0j7o8Ub-bpX6FihJVost124kbBt-78OlC3vce9Mqq1A8AEYYLk0psuDvjZAk3NFaCs0SqxDGcBfDS4iH3yqPOm7iMpLmHTu6gk7fQCQAvQZNLT-Lueomcrn-o3z00azlM1g9_59DYDXUE5M2Fan6ce32WK06ySMWaFKSgQolMWtdYaWq3LBaRMgFsLfF4_mLnYAzgWXfb6jN3SFWUujqzYyhlGcXWTARwv4V-txKC7X5jFgXAVoRiZamrd8rpScOZbqPmlGb44fplPYWrewejYT4cjPcfwTXscivu8DDdgt5ifqYfw2X5fTGt50-84CP4fNFC8xtEtpd- |
| linkToPdf | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V1Lb9QwEB6VgiouvB-BAkYCicNGm9hOHCMhBC0rqrargkDqLY1f7aKSLJstiL_Gr8N2vCmL0N564Go7luN88_B48g3AM0G5wopWsXb5OlTzNBaEVTFnhkhFOakqT5m_x8bj4vCQH6zBr8W_MC6tcqETvaJWjXQx8qE1JNSRzBbp0IS0iIPt0evpt9hVkHI3rYtyGh1EdvXPH_b41r7a2bbf-jnGo3eftt7HocJALDLC53FqKMlNUlAttau7naicSsmrPNGpMYwLyXhWFNyxzInUMG0totLGHhuzTCZKEDvvJbjMaIYdb_9-8rGP71hXiWcZDkRHKcmH4usXVxHL4tL9N-RoYKg1aLZ1yST6ygH_cnf_ztr8wwyOrv_PG3gDrgXnG73ppOUmrOn6Fmzsh_SC2zDdsjYdWTcenYRyKsgnucTzJg4EtMhLDDrVx5O2SyNEkxp98OEAlyQ6QH30aNDP0r5EVY0a0UfA7cSe1_cOfL6Q970L63VT6_uACMOVySU23N18sowbmirBWSZV5njPInhhsVEGldKW_rRG8jLAqHQwKjsYRYAXACploHZ3FUZOVz806B-adswmq4e_dcjshzpact_QzI7LoOVKxUmRqFSTilRUKFFI6zArTe2WpSJRJoLNBTbPX-wcmBE87butlnNXV1WtmzM7hlJWUGyNRwT3OjHoV0Kw3W_MkgjYkoAsLXW5p56ceCZ1e5bOaYEfrF7WE9iwklLu7Yx3H8JV7AIu7kYx34T1-exMP4Ir8vt80s4eew2A4OiiJeY32byeuA |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Case+for+hospital+nurse-to-patient+ratio+legislation+in+Queensland%2C+Australia%2C+hospitals%3A+an+observational+study&rft.jtitle=BMJ+open&rft.au=McHugh%2C+Matthew+D&rft.au=Aiken%2C+Linda+H&rft.au=Windsor%2C+Carol&rft.au=Douglas%2C+Clint&rft.date=2020-09-06&rft.pub=BMJ+Publishing+Group+LTD&rft.eissn=2044-6055&rft.volume=10&rft.issue=9&rft.spage=e036264&rft_id=info:doi/10.1136%2Fbmjopen-2019-036264&rft.externalDBID=HAS_PDF_LINK |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2044-6055&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2044-6055&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2044-6055&client=summon |