Effects of nurse staffing, work environments, and education on patient mortality: An observational study
While considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea. To examine the effects of nurse staffing, work environment, and education on patien...
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| Published in: | International journal of nursing studies Vol. 52; no. 2; pp. 535 - 542 |
|---|---|
| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Elsevier Ltd
01.02.2015
Elsevier Limited |
| Subjects: | |
| ISSN: | 0020-7489, 1873-491X, 1873-491X |
| Online Access: | Get full text |
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| Abstract | While considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea.
To examine the effects of nurse staffing, work environment, and education on patient mortality.
This study linked hospital facility data with staff nurse survey data (N=1024) and surgical patient discharge data (N=76,036) from 14 high-technology teaching hospitals with 700 or more beds in South Korea, collected between January 1, 2008 and December 31, 2008. Logistic regression models that corrected for the clustering of patients in hospitals were used to estimate the effects of the three nursing characteristics on risk-adjusted patient mortality within 30 days of admission.
Risk-adjusted models reveal that nurse staffing, nurse work environments, and nurse education were significantly associated with patient mortality (OR 1.05, 95% CI 1.00–1.10; OR 0.52, 95% CI 0.31–0.88; and OR 0.91, CI 0.83–0.99; respectively). These odds ratios imply that each additional patient per nurse is associated with an 5% increase in the odds of patient death within 30 days of admission, that the odds of patient mortality are nearly 50% lower in the hospitals with better nurse work environments than in hospitals with mixed or poor nurse work environments, and that each 10% increase in nurses having Bachelor of Science in Nursing Degree is associated with a 9% decrease in patient deaths.
Nurse staffing, nurse work environments, and percentages of nurses having Bachelor of Science in Nursing Degree in South Korea are associated with patient mortality. Improving hospital nurse staffing and work environments and increasing the percentages of nurses having Bachelor of Science in Nursing Degree would help reduce the number of preventable in-hospital deaths. |
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| AbstractList | While considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea.
To examine the effects of nurse staffing, work environment, and education on patient mortality.
This study linked hospital facility data with staff nurse survey data (N=1024) and surgical patient discharge data (N=76,036) from 14 high-technology teaching hospitals with 700 or more beds in South Korea, collected between January 1, 2008 and December 31, 2008. Logistic regression models that corrected for the clustering of patients in hospitals were used to estimate the effects of the three nursing characteristics on risk-adjusted patient mortality within 30 days of admission.
Risk-adjusted models reveal that nurse staffing, nurse work environments, and nurse education were significantly associated with patient mortality (OR 1.05, 95% CI 1.00–1.10; OR 0.52, 95% CI 0.31–0.88; and OR 0.91, CI 0.83–0.99; respectively). These odds ratios imply that each additional patient per nurse is associated with an 5% increase in the odds of patient death within 30 days of admission, that the odds of patient mortality are nearly 50% lower in the hospitals with better nurse work environments than in hospitals with mixed or poor nurse work environments, and that each 10% increase in nurses having Bachelor of Science in Nursing Degree is associated with a 9% decrease in patient deaths.
Nurse staffing, nurse work environments, and percentages of nurses having Bachelor of Science in Nursing Degree in South Korea are associated with patient mortality. Improving hospital nurse staffing and work environments and increasing the percentages of nurses having Bachelor of Science in Nursing Degree would help reduce the number of preventable in-hospital deaths. While considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea. To examine the effects of nurse staffing, work environment, and education on patient mortality. This study linked hospital facility data with staff nurse survey data (N = 1024) and surgical patient discharge data (N = 76,036) from 14 high-technology teaching hospitals with 700 or more beds in South Korea, collected between January 1, 2008 and December 31, 2008. Logistic regression models that corrected for the clustering of patients in hospitals were used to estimate the effects of the three nursing characteristics on risk-adjusted patient mortality within 30 days of admission. Risk-adjusted models reveal that nurse staffing, nurse work environments, and nurse education were significantly associated with patient mortality (OR 1.05, 95% CI 1.00-1.10; OR 0.52, 95% CI 0.31-0.88; and OR 0.91, CI 0.83-0.99; respectively). These odds ratios imply that each additional patient per nurse is associated with an 5% increase in the odds of patient death within 30 days of admission, that the odds of patient mortality are nearly 50% lower in the hospitals with better nurse work environments than in hospitals with mixed or poor nurse work environments, and that each 10% increase in nurses having Bachelor of Science in Nursing Degree is associated with a 9% decrease in patient deaths. Nurse staffing, nurse work environments, and percentages of nurses having Bachelor of Science in Nursing Degree in South Korea are associated with patient mortality. Improving hospital nurse staffing and work environments and increasing the percentages of nurses having Bachelor of Science in Nursing Degree would help reduce the number of preventable in-hospital deaths. 28 references While considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea.BACKGROUNDWhile considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea.To examine the effects of nurse staffing, work environment, and education on patient mortality.OBJECTIVETo examine the effects of nurse staffing, work environment, and education on patient mortality.This study linked hospital facility data with staff nurse survey data (N=1024) and surgical patient discharge data (N=76,036) from 14 high-technology teaching hospitals with 700 or more beds in South Korea, collected between January 1, 2008 and December 31, 2008. Logistic regression models that corrected for the clustering of patients in hospitals were used to estimate the effects of the three nursing characteristics on risk-adjusted patient mortality within 30 days of admission.METHODSThis study linked hospital facility data with staff nurse survey data (N=1024) and surgical patient discharge data (N=76,036) from 14 high-technology teaching hospitals with 700 or more beds in South Korea, collected between January 1, 2008 and December 31, 2008. Logistic regression models that corrected for the clustering of patients in hospitals were used to estimate the effects of the three nursing characteristics on risk-adjusted patient mortality within 30 days of admission.Risk-adjusted models reveal that nurse staffing, nurse work environments, and nurse education were significantly associated with patient mortality (OR 1.05, 95% CI 1.00-1.10; OR 0.52, 95% CI 0.31-0.88; and OR 0.91, CI 0.83-0.99; respectively). These odds ratios imply that each additional patient per nurse is associated with an 5% increase in the odds of patient death within 30 days of admission, that the odds of patient mortality are nearly 50% lower in the hospitals with better nurse work environments than in hospitals with mixed or poor nurse work environments, and that each 10% increase in nurses having Bachelor of Science in Nursing Degree is associated with a 9% decrease in patient deaths.RESULTSRisk-adjusted models reveal that nurse staffing, nurse work environments, and nurse education were significantly associated with patient mortality (OR 1.05, 95% CI 1.00-1.10; OR 0.52, 95% CI 0.31-0.88; and OR 0.91, CI 0.83-0.99; respectively). These odds ratios imply that each additional patient per nurse is associated with an 5% increase in the odds of patient death within 30 days of admission, that the odds of patient mortality are nearly 50% lower in the hospitals with better nurse work environments than in hospitals with mixed or poor nurse work environments, and that each 10% increase in nurses having Bachelor of Science in Nursing Degree is associated with a 9% decrease in patient deaths.Nurse staffing, nurse work environments, and percentages of nurses having Bachelor of Science in Nursing Degree in South Korea are associated with patient mortality. Improving hospital nurse staffing and work environments and increasing the percentages of nurses having Bachelor of Science in Nursing Degree would help reduce the number of preventable in-hospital deaths.CONCLUSIONSNurse staffing, nurse work environments, and percentages of nurses having Bachelor of Science in Nursing Degree in South Korea are associated with patient mortality. Improving hospital nurse staffing and work environments and increasing the percentages of nurses having Bachelor of Science in Nursing Degree would help reduce the number of preventable in-hospital deaths. While considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea. To examine the effects of nurse staffing, work environment, and education on patient mortality. This study linked hospital facility data with staff nurse survey data (N = 1024) and surgical patient discharge data (N = 76,036) from 14 high-technology teaching hospitals with 700 or more beds in South Korea, collected between January 1, 2008 and December 31, 2008. Logistic regression models that corrected for the clustering of patients in hospitals were used to estimate the effects of the three nursing characteristics on risk-adjusted patient mortality within 30 days of admission. Risk-adjusted models reveal that nurse staffing, nurse work environments, and nurse education were significantly associated with patient mortality (OR 1.05, 95% CI 1.00-1.10; OR 0.52, 95% CI 0.31-0.88; and OR 0.91, CI 0.83-0.99; respectively). These odds ratios imply that each additional patient per nurse is associated with an 5% increase in the odds of patient death within 30 days of admission, that the odds of patient mortality are nearly 50% lower in the hospitals with better nurse work environments than in hospitals with mixed or poor nurse work environments, and that each 10% increase in nurses having Bachelor of Science in Nursing Degree is associated with a 9% decrease in patient deaths. Nurse staffing, nurse work environments, and percentages of nurses having Bachelor of Science in Nursing Degree in South Korea are associated with patient mortality. Improving hospital nurse staffing and work environments and increasing the percentages of nurses having Bachelor of Science in Nursing Degree would help reduce the number of preventable in-hospital deaths. |
| Author | Sloane, Douglas M. Cho, Eunhee Kim, Eun-Young Lee, Hye Sun Choi, Miyoung Kim, Sera Aiken, Linda H. Yoo, Il Young |
| AuthorAffiliation | g Department of Biostatistics, Yonsei University College of Medicine, Seoul, South Korea d Health Insurance Review & Assessment Service, Seoul, South Korea c Dong-A University Department of Nursing, Busan, South Korea e National Evidence-Based Healthcare Collaborating Agency, Seoul, South Korea a Nursing Policy Research Institute, Yonsei University College of Nursing, Seoul, South Korea b Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, PA, USA f Nursing Policy Research Institute, Yonsei University College of Nursing, Seoul, South Korea |
| AuthorAffiliation_xml | – name: a Nursing Policy Research Institute, Yonsei University College of Nursing, Seoul, South Korea – name: b Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, PA, USA – name: e National Evidence-Based Healthcare Collaborating Agency, Seoul, South Korea – name: d Health Insurance Review & Assessment Service, Seoul, South Korea – name: g Department of Biostatistics, Yonsei University College of Medicine, Seoul, South Korea – name: c Dong-A University Department of Nursing, Busan, South Korea – name: f Nursing Policy Research Institute, Yonsei University College of Nursing, Seoul, South Korea |
| Author_xml | – sequence: 1 givenname: Eunhee surname: Cho fullname: Cho, Eunhee organization: Nursing Policy Research Institute, Yonsei University College of Nursing, Seoul, South Korea – sequence: 2 givenname: Douglas M. surname: Sloane fullname: Sloane, Douglas M. organization: Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, PA, USA – sequence: 3 givenname: Eun-Young surname: Kim fullname: Kim, Eun-Young email: eykim@dau.ac.kr organization: Dong-A University, Department of Nursing, Busan, South Korea – sequence: 4 givenname: Sera surname: Kim fullname: Kim, Sera organization: Health Insurance Review & Assessment Service, Seoul, South Korea – sequence: 5 givenname: Miyoung surname: Choi fullname: Choi, Miyoung organization: National Evidence-Based Healthcare Collaborating Agency, Seoul, South Korea – sequence: 6 givenname: Il Young surname: Yoo fullname: Yoo, Il Young organization: Nursing Policy Research Institute, Yonsei University College of Nursing, Seoul, South Korea – sequence: 7 givenname: Hye Sun surname: Lee fullname: Lee, Hye Sun organization: Department of Biostatistics, Yonsei University College of Medicine, Seoul, South Korea – sequence: 8 givenname: Linda H. surname: Aiken fullname: Aiken, Linda H. organization: Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, PA, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25213091$$D View this record in MEDLINE/PubMed |
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| Copyright | 2014 Elsevier Ltd Copyright © 2014 Elsevier Ltd. All rights reserved. Copyright Elsevier Science Ltd. Feb 2015 2014 Elsevier Ltd. All rights reserved. 2014 |
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| Title | Effects of nurse staffing, work environments, and education on patient mortality: An observational study |
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