Associations between rates of unassisted inpatient falls and levels of registered and non-registered nurse staffing

Objective. To enhance understanding of how nurse staffing relates to unassisted falls by exploring non-linear associations between unassisted fall rates and levels of registered nurse (RN) and non-RN staffing on 5 nursing unit types, thereby enabling managers to improve patient safety by making bett...

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Bibliographic Details
Published in:International journal for quality in health care 2014-02, Vol.26 (1), p.87-92
Main Authors: STAGGS, VINCENT S., DUNTON, NANCY
Format: Article
Language:English
Subjects:
Accidental Falls - statistics & numerical data
Biological and medical sciences
Cross-Sectional Studies
Health participants
Hospitals - manpower
Hospitals - standards
Hospitals - statistics & numerical data
Humans
Medical sciences
Nursing Staff, Hospital - standards
Nursing Staff, Hospital - statistics & numerical data
Public health. Hygiene
Public health. Hygiene-occupational medicine
Quality Indicators, Health Care - statistics & numerical data
United States - epidemiology
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Summary:Objective. To enhance understanding of how nurse staffing relates to unassisted falls by exploring non-linear associations between unassisted fall rates and levels of registered nurse (RN) and non-RN staffing on 5 nursing unit types, thereby enabling managers to improve patient safety by making better-informed decisions about staffing. Design. Crass-sectional analysis of routinely collected data using hierarchical negative binomial regression. Settings. 8069 nursing units in 1361 U.S. hospitals participating in the National Database of Nursing Quality Indicators®. Main outcome measure. Rate of unassisted falls per inpatient day. Results. Associations between unassisted fall rates and nurse staffing varied by unit type. For medical-surgical units, higher RN staffing was weakly associated with lower fall rates. On step-down and medical units, the association between RN staffing and fall rates depended on the level of staffing: At lower staffing levels, the fall rate increased as staffing increased, but at moderate and high staffing levels, the fall rate decreased as staffing increased. Higher levels of non-RN staffing were generally associated with higher fall rates. Conclusions. Increasing non-RN staffing seems ineffective at preventing unassisted falls. Increasing RN staffing may be effective, depending on the unit type and the current level of staffing.
ISSN:1353-4505
1464-3677
DOI:10.1093/intqhc/mzt080