The relationship between nurse staffing, nursing time, and adverse events in an acute care hospital
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Robyn B. Cheung, ADN, BSN, MSN, PhD
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Studies have shown that nurse-staffing patterns affect patient safety, but it is not known how staffing patterns affect time spent in direct and indirect care. This study explores the relationships between nurse staffing, registered nurse (RN) time spent in direct and indirect care, and the occurrence of adverse events on 5 inpatient units in an acute care hospital. Time spent in direct and indirect care was determined by examining patterns of electronically recorded data that captured, via locator badges, continuous intervals of time. Electronic data were captured using the Hill-Rom COMposer® nurse locator system. The average amount of time RNs spend in direct care per shift is 54% and 42% in indirect care. The multivariate model that includes the proportion of RN hours, unit acuity, and unit secretary hours best explains the variance in the percent of RN time spent in direct care (R2 = .188, p = .000). Results from regression procedures predict that RNs spend 31.5% more time in direct care as the proportion of RN hours increase and 2.7% more time in direct care as hours of unit secretary increase. The largest effect size in the model is for the percentage of RN hours (η 2 = .127). The effect size for unit secretary is η2 = .014. No significant relationships were found between adverse events, ratios of nurse staffing, or percent of RN time spent in direct or indirect care. The study findings indicate that RN time is driven by the proportion of RN hours in the skill mix, and highlights the important contribution the unit secretary makes in allowing RNs to spend more time in direct care. The findings from this study emphasize the importance of using staffing variables that distinguish between the unique contributions of the RN and LPN proportion in the skill mix. This study, the first to use electronic technology to measure RN time spent in direct and indirect care, demonstrates that this method of data collection provides data that permit researchers to examine key variables related to nurse staffing and patient outcomes in acute and long term care settings.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3052636; ProQuest document ID: 305513960. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Other |
Research Approach | Quantitative Research |
Keywords | Staffing Patterns; Indirect Care; Direct Care; Patient Safety; Time Spent with Patients |
Grantor | University of South Florida |
Advisor | Moody, Linda; Beckstead, Jason; Lenacher, Cecile; Rich, Victoria |
Level | PhD |
Year | 2002 |
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