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Using Minimum Nurse Staffing Regulations to Measure the Relationship Between Nursing and Hospital Quality of Care
This study tests whether changes in licensed nurse staffing led to changes in patient safety, using the natural experiment of 2004 California implementation of minimum staffing ratios. We calculated counts of six patient safety outcomes from California Patient Discharge Data from 2000 through 2006,...
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| Published in: | Medical care research and review 2013-08, Vol.70 (4), p.380-399 |
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| Main Authors: | , , , |
| Format: | Article |
| Language: | English |
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| cited_by | cdi_FETCH-LOGICAL-c398t-741fa10996539d04ed1e18a21db5e94325febd6b6de972e46a6e81fcc0454e043 |
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| cites | cdi_FETCH-LOGICAL-c398t-741fa10996539d04ed1e18a21db5e94325febd6b6de972e46a6e81fcc0454e043 |
| container_end_page | 399 |
| container_issue | 4 |
| container_start_page | 380 |
| container_title | Medical care research and review |
| container_volume | 70 |
| creator | Spetz, Joanne Harless, David W. Herrera, Carolina-Nicole Mark, Barbara A. |
| description | This study tests whether changes in licensed nurse staffing led to changes in patient safety, using the natural experiment of 2004 California implementation of minimum staffing ratios. We calculated counts of six patient safety outcomes from California Patient Discharge Data from 2000 through 2006, using the Agency for Healthcare Research and Quality Patient Safety Indicators (PSI) software. For patients experiencing nonmortality-related PSIs, we measured mean lengths of stay. We estimated difference-in-difference equations of changes in PSIs using Poisson models and calculated the marginal impact of nurse staffing on outcomes from fixed-effect Poisson regressions. Licensed nurse staffing increased in the postregulation period, except for hospitals in the highest quartile of preregulation staffing. Growth in registered nurse staffing was associated with improvement for only one PSI and reduced length of stay for one PSI. Higher registered nurse staffing per patient day had a limited impact on adverse events in California hospitals. |
| doi_str_mv | 10.1177/1077558713475715 |
| format | article |
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We calculated counts of six patient safety outcomes from California Patient Discharge Data from 2000 through 2006, using the Agency for Healthcare Research and Quality Patient Safety Indicators (PSI) software. For patients experiencing nonmortality-related PSIs, we measured mean lengths of stay. We estimated difference-in-difference equations of changes in PSIs using Poisson models and calculated the marginal impact of nurse staffing on outcomes from fixed-effect Poisson regressions. Licensed nurse staffing increased in the postregulation period, except for hospitals in the highest quartile of preregulation staffing. Growth in registered nurse staffing was associated with improvement for only one PSI and reduced length of stay for one PSI. Higher registered nurse staffing per patient day had a limited impact on adverse events in California hospitals.</description><identifier>ISSN: 1077-5587</identifier><identifier>EISSN: 1552-6801</identifier><identifier>DOI: 10.1177/1077558713475715</identifier><identifier>PMID: 23401064</identifier><identifier>CODEN: MCRRFH</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>California ; Clinical outcomes ; Government Regulation ; Hospitals ; Humans ; Length of stay ; Nurses ; Nursing ; Nursing Staff, Hospital - organization & administration ; Patient care ; Patient Safety ; Personnel Staffing and Scheduling - legislation & jurisprudence ; Poisson Distribution ; Quality of care ; Quality of Health Care - standards ; Safety measures ; Staffing ; State regulation ; Workforce planning</subject><ispartof>Medical care research and review, 2013-08, Vol.70 (4), p.380-399</ispartof><rights>The Author(s) 2013</rights><rights>Copyright SAGE PUBLICATIONS, INC. 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We calculated counts of six patient safety outcomes from California Patient Discharge Data from 2000 through 2006, using the Agency for Healthcare Research and Quality Patient Safety Indicators (PSI) software. For patients experiencing nonmortality-related PSIs, we measured mean lengths of stay. We estimated difference-in-difference equations of changes in PSIs using Poisson models and calculated the marginal impact of nurse staffing on outcomes from fixed-effect Poisson regressions. Licensed nurse staffing increased in the postregulation period, except for hospitals in the highest quartile of preregulation staffing. Growth in registered nurse staffing was associated with improvement for only one PSI and reduced length of stay for one PSI. Higher registered nurse staffing per patient day had a limited impact on adverse events in California hospitals.</description><subject>California</subject><subject>Clinical outcomes</subject><subject>Government Regulation</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Length of stay</subject><subject>Nurses</subject><subject>Nursing</subject><subject>Nursing Staff, Hospital - organization & administration</subject><subject>Patient care</subject><subject>Patient Safety</subject><subject>Personnel Staffing and Scheduling - legislation & jurisprudence</subject><subject>Poisson Distribution</subject><subject>Quality of care</subject><subject>Quality of Health Care - standards</subject><subject>Safety measures</subject><subject>Staffing</subject><subject>State regulation</subject><subject>Workforce planning</subject><issn>1077-5587</issn><issn>1552-6801</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNqNkUtrFEEUhQtRzEP3rqTAjZvWuvWupQ4xERLFR9ZNTfftSYV-TOqB5N9b44wiAcHVLe75zrkUh5AXwN4AGPMWmDFKWQNCGmVAPSLHoBRvtGXwuL6r3Oz0I3KS0i1jTHIrnpIjLiQDpuUxubtOYd7QqzCHqUz0U4kJ6bfsh2G3_oqbMvocljnRvNAr9KlEpPkGq3QQbsKWvsf8A3H-Zd_5_NzTiyVtQ_Yj_VL8GPI9XQa68hGfkSeDHxM-P8xTcv3h7Pvqorn8fP5x9e6y6YSzuTESBg_MOa2E65nEHhCs59CvFTopuBpw3eu17tEZjlJ7jRaGrmNSSWRSnJLX-9xtXO4KptxOIXU4jn7GpaQWpHTMWe7cf6CMaQ7WsIq-eoDeLiXO9SOVAi600GArxfZUF5eUIg7tNobJx_sWWLtrrn3YXLW8PASX9YT9H8PvqirQ7IHkN_jX1X8F_gRRu59r</recordid><startdate>201308</startdate><enddate>201308</enddate><creator>Spetz, Joanne</creator><creator>Harless, David W.</creator><creator>Herrera, Carolina-Nicole</creator><creator>Mark, Barbara A.</creator><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201308</creationdate><title>Using Minimum Nurse Staffing Regulations to Measure the Relationship Between Nursing and Hospital Quality of Care</title><author>Spetz, Joanne ; Harless, David W. ; Herrera, Carolina-Nicole ; Mark, Barbara A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-741fa10996539d04ed1e18a21db5e94325febd6b6de972e46a6e81fcc0454e043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>California</topic><topic>Clinical outcomes</topic><topic>Government Regulation</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Length of stay</topic><topic>Nurses</topic><topic>Nursing</topic><topic>Nursing Staff, Hospital - organization & administration</topic><topic>Patient care</topic><topic>Patient Safety</topic><topic>Personnel Staffing and Scheduling - legislation & jurisprudence</topic><topic>Poisson Distribution</topic><topic>Quality of care</topic><topic>Quality of Health Care - standards</topic><topic>Safety measures</topic><topic>Staffing</topic><topic>State regulation</topic><topic>Workforce planning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Spetz, Joanne</creatorcontrib><creatorcontrib>Harless, David W.</creatorcontrib><creatorcontrib>Herrera, Carolina-Nicole</creatorcontrib><creatorcontrib>Mark, Barbara A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Medical care research and review</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spetz, Joanne</au><au>Harless, David W.</au><au>Herrera, Carolina-Nicole</au><au>Mark, Barbara A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Using Minimum Nurse Staffing Regulations to Measure the Relationship Between Nursing and Hospital Quality of Care</atitle><jtitle>Medical care research and review</jtitle><addtitle>Med Care Res Rev</addtitle><date>2013-08</date><risdate>2013</risdate><volume>70</volume><issue>4</issue><spage>380</spage><epage>399</epage><pages>380-399</pages><issn>1077-5587</issn><eissn>1552-6801</eissn><coden>MCRRFH</coden><abstract>This study tests whether changes in licensed nurse staffing led to changes in patient safety, using the natural experiment of 2004 California implementation of minimum staffing ratios. 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| fulltext | fulltext |
| identifier | ISSN: 1077-5587 |
| ispartof | Medical care research and review, 2013-08, Vol.70 (4), p.380-399 |
| issn | 1077-5587 1552-6801 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1449098299 |
| source | Applied Social Sciences Index & Abstracts (ASSIA); SAGE |
| subjects | California Clinical outcomes Government Regulation Hospitals Humans Length of stay Nurses Nursing Nursing Staff, Hospital - organization & administration Patient care Patient Safety Personnel Staffing and Scheduling - legislation & jurisprudence Poisson Distribution Quality of care Quality of Health Care - standards Safety measures Staffing State regulation Workforce planning |
| title | Using Minimum Nurse Staffing Regulations to Measure the Relationship Between Nursing and Hospital Quality of Care |
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