Quality Matters: Examining the Impact of Nurse Staffing Challenges on Clinical Outcomes.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-05-01 DOI:10.1097/JHM-D-22-00170

Shea Polancich, Rebecca Miltner, Aoyjai Montgomery, Tracey Dick, Terri Poe, Daran Brown, Patricia A Patrician

{"title":"Quality Matters: Examining the Impact of Nurse Staffing Challenges on Clinical Outcomes.","authors":"Shea Polancich, Rebecca Miltner, Aoyjai Montgomery, Tracey Dick, Terri Poe, Daran Brown, Patricia A Patrician","doi":"10.1097/JHM-D-22-00170","DOIUrl":null,"url":null,"abstract":"Goal: The purpose of this study was to examine nurse staffing while describing the relationships that exist in staffing and quality associated with nursing care during the COVID-19 pandemic, a significantly challenging time for nurse staffing. We examined the relationship between permanent registered nurse (RN) and travel RN staffing during the pandemic and the nursing-sensitive outcomes of catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), falls, and hospital-acquired pressure injuries (HAPIs) and length of stay and compared the cost of CAUTIs, CLABSIs, falls, and HAPIs in fiscal years 2021 and 2022. Methods: We used a descriptive, observational design to retrospectively examine permanent nurse staffing volume and CAUTI, CLABSI, HAPI, and fall counts from October 1, 2019, to February 28, 2022, and travel nurse volume for the most current 12 months, April 1, 2021, to March 31, 2022. Descriptive statistics, Pearson correlation, and statistical process control analyses were completed. Principal Findings: Pearson correlation showed a statistically significant, moderately strong negative correlation (r = −0.568, p = .001) between the active registered nurse full-time equivalents (RN FTEs) and average length of stay (ALOS), and a moderately strong positive correlation (r = 0.688, p = .013) between the travel RN FTEs and ALOS. Pearson correlations were not statistically significant, with low to moderate negative correlations for CAUTIs (r = −0.052, p = .786), CLABSIs (r = −0.207, p = .273), and falls (r = −0.056, p = .769). Pearson correlation for active RN and HAPI showed a moderately strong, statistically significant positive correlation (r = 0.499, p = .003). We observed common cause variation in CAUTIs and CLABSIs, with HAPIs and falls showing special cause variation via statistical process control. Practical Applications: Despite the challenges associated with the lack of available nurse staffing accompanied by increasing responsibilities including unlicensed tasks, positive clinical outcomes can be maintained by staff adherence to evidence-based quality improvement.","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/JHM-D-22-00170","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}

引用次数: 0

Abstract

Goal: The purpose of this study was to examine nurse staffing while describing the relationships that exist in staffing and quality associated with nursing care during the COVID-19 pandemic, a significantly challenging time for nurse staffing. We examined the relationship between permanent registered nurse (RN) and travel RN staffing during the pandemic and the nursing-sensitive outcomes of catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), falls, and hospital-acquired pressure injuries (HAPIs) and length of stay and compared the cost of CAUTIs, CLABSIs, falls, and HAPIs in fiscal years 2021 and 2022. Methods: We used a descriptive, observational design to retrospectively examine permanent nurse staffing volume and CAUTI, CLABSI, HAPI, and fall counts from October 1, 2019, to February 28, 2022, and travel nurse volume for the most current 12 months, April 1, 2021, to March 31, 2022. Descriptive statistics, Pearson correlation, and statistical process control analyses were completed. Principal Findings: Pearson correlation showed a statistically significant, moderately strong negative correlation (r = −0.568, p = .001) between the active registered nurse full-time equivalents (RN FTEs) and average length of stay (ALOS), and a moderately strong positive correlation (r = 0.688, p = .013) between the travel RN FTEs and ALOS. Pearson correlations were not statistically significant, with low to moderate negative correlations for CAUTIs (r = −0.052, p = .786), CLABSIs (r = −0.207, p = .273), and falls (r = −0.056, p = .769). Pearson correlation for active RN and HAPI showed a moderately strong, statistically significant positive correlation (r = 0.499, p = .003). We observed common cause variation in CAUTIs and CLABSIs, with HAPIs and falls showing special cause variation via statistical process control. Practical Applications: Despite the challenges associated with the lack of available nurse staffing accompanied by increasing responsibilities including unlicensed tasks, positive clinical outcomes can be maintained by staff adherence to evidence-based quality improvement.

查看原文本刊更多论文

质量问题:检查护士人员配置挑战对临床结果的影响。

目的:本研究的目的是检查护士人员配置，同时描述在COVID-19大流行期间与护理相关的人员配置和质量之间存在的关系，这是护士人员配置面临的重大挑战。我们研究了大流行期间永久注册护士(RN)和旅行护士配备与导尿管相关尿路感染(CAUTIs)、中心线相关血流感染(CLABSIs)、跌倒和医院获得性压力损伤(HAPIs)和住院时间的护理敏感结果之间的关系，并比较了2021财年和2022财年CAUTIs、CLABSIs、跌倒和HAPIs的成本。方法:采用描述性观察性设计，回顾性分析2019年10月1日至2022年2月28日的常住护士人数、CAUTI、CLABSI、HAPI和跌倒计数，以及最近12个月(2021年4月1日至2022年3月31日)的旅行护士人数。完成描述性统计、Pearson相关分析和统计过程控制分析。主要发现:Pearson相关分析显示，在职注册护士全职当量(RN FTEs)与平均住院时间(ALOS)呈中强负相关(r = -0.568, p = .001)，旅行注册护士全职当量(RN FTEs)与平均住院时间(ALOS)呈中强正相关(r = 0.688, p = .013)。Pearson相关性无统计学意义，CAUTIs (r = -0.052, p = .786)、clabsi (r = -0.207, p = .273)和falls (r = -0.056, p = .769)呈低至中度负相关。活跃RN与HAPI的Pearson相关性为中强，有统计学意义的正相关(r = 0.499, p = 0.003)。我们观察到CAUTIs和clabsi的共同原因变化，而HAPIs和falls通过统计过程控制显示出特殊原因变化。实际应用:尽管面临着护士人手不足的挑战，以及包括无证任务在内的责任增加，但通过员工坚持循证质量改进，可以保持积极的临床结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.