Twenty years of staffing, practice environment, and outcomes research in military nursing

• Published in: Nursing outlook 2017-09, Vol.65 (5), p.S120-S129
• Main Authors: Patrician, Patricia A., Loan, Lori A., McCarthy, Mary S., Swiger, Pauline, Breckenridge-Sproat, Sara, Brosch, Laura Ruse, Jennings, Bonnie Mowinski
• Format: Article
• Language: English
• Subjects: Humans; Military Nursing - organization & administration; Nursing; Nursing sensitive indicators; Nursing Staff, Hospital; Outcome Assessment (Health Care); Outcomes; Personnel Staffing and Scheduling - organization & administration; Practice environment; Practice Patterns, Nurses' - organization & administration; Quality of Health Care; Staffing; United States; Workload
• ISSN: 0029-6554; 1528-3968
• DOI: 10.1016/j.outlook.2017.06.015

Two decades ago, findings from an Institute of Medicine (IOM) report sparked the urgent need for evidence supporting relationships between nurse staffing and patient outcomes. This article provides an overview of nurse staffing, practice environment, and patient outcomes research, with an emphasis on findings from military studies. Lessons learned also are enumerated. This study is a review of the entire Military Nursing Outcomes Database (MilNOD) program of research. The MilNOD, in combination with evidence from other health care studies, provides nurses and leaders with information about the associations between staffing, patient outcomes, and the professional practice environment of nursing in the military. Leaders, therefore, have useful empirical evidence to make data-driven decisions. The MilNOD studies are the basis for the current Army nursing dashboard, and care delivery framework, called the Patent CaringTouch System. Future research is needed to identify ideal staffing based on workload demands, and provide leaders with factors to consider when operationalizing staffing recommendations. •Standardized accessible data for secondary analysis to study nurse staffing and patient outcomes were not available in the military hospitals.•Military nurse researches used civilian studies to identify best designs, methods, and analysis techniques.•Military Nursing Outcomes Database (MilNOD) methodologies support the analysis of staffing on patient outcomes using shift-level data.•Findings from the MilNOD have helped to reduce adverse patient outcomes in military hospitals.