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Effects of nurse staffing, work environments, and education on patient mortality: an observational study

Authors
 Eunhee Cho  ;  Douglas M. Sloane  ;  Eun-Young Kim  ;  Sera Kim  ;  Miyoung Choi  ;  Il Young Yoo  ;  Hye Sun Lee  ;  Linda H. Aiken 
Citation
 International Journal of Nursing Studies, Vol.52(2) : 535-542, 2015 
Journal Title
 International Journal of Nursing Studies 
ISSN
 0020-7489 
Issue Date
2015
Abstract
BACKGROUND: 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. OBJECTIVE: To examine the effects of nurse staffing, work environment, and education on patient mortality. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0020748914002090
DOI
10.1016/j.ijnurstu.2014.08.006
Appears in Collections:
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
3. College of Nursing (간호대학) > Dept. of Nursing (간호학과) > 1. Journal Papers
Yonsei Authors
Yoo, Il Young(유일영)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Cho, Eunhee(조은희) ORCID logo https://orcid.org/0000-0002-7871-6848
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139343
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