Outcomes of Nurse Practice Environments

Summary

Principal Investigator: Linda Aiken
Affiliation: University of Pennsylvania
Country: USA
Abstract: [unreadable] DESCRIPTION (provided by applicant): We seek to develop through a revised competing continuation (NR04513) a greater understanding of the effects of nurse staffing and the nurse practice environment on nurse and patient outcomes by exploiting natural experiments that are anticipated to change staffing and practice environments and exploring the effects of those factors over time, and across different states, using multiple methods and measures. We propose to extend our 1999 study of the outcomes of nurse staffing and nurse practice environments in 182 Pennsylvania hospitals at a second point in time (in 2006) and, in that same year, extend our study to include parallel data from roughly 402 hospitals in California, where mandatory nurse staffing ratio legislation has created the largest natural experiment ever in hospital nurse staffing change. We will also, for all hospitals in both states, and for every year from 1998 to 2007, compile hospital-level data on staffing and hospital-level and patient-level data on mortality and other adverse events. The expanded cross-sectional data for 2006 will enable us to resolve many of the questions involving how best to measure and disentangle the potentially interactive effects of nurse staffing (including nurse education) and nurse practice environments on nurse and patient outcomes. The repeated cross-sectional data from Pennsylvania, and the longitudinal data on staffing and patient outcomes from both states, will provide better evidence for establishing the causal relationships between nurse staffing, nurse education, nurse practice environments, and nurse and patient outcomes, since investigating changes in hospitals over time involves using each hospital as its own control. The use of patient outcomes beyond mortality and failure to rescue will allow us to more completely capture the effects of nurses and nursing on the large number of patients who, while not at great risk of dying, are nonetheless vulnerable to a wide range of unfavorable outcomes. This research has the potential to advance the field of nursing outcomes research and to yield critical insights relevant to stemming the flight of nurses from front line care roles and improving hospital outcomes. [unreadable] [unreadable]
Funding Period: 1997-07-15 - 2009-05-31
more information: NIH RePORT

Top Publications

  1. pmc Relationship between psychiatric nurse work environments and nurse burnout in acute care general hospitals
    Nancy P Hanrahan
    University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania 19104, USA
    Issues Ment Health Nurs 31:198-207. 2010
  2. pmc Lower mortality in magnet hospitals
    Matthew D McHugh
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104 4217, USA
    Med Care 51:382-8. 2013
  3. pmc Hospital staff nurses' shift length associated with safety and quality of care
    Amy Witkoski Stimpfel
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA
    J Nurs Care Qual 28:122-9. 2013
  4. pmc Nurse reported quality of care: a measure of hospital quality
    Matthew D McHugh
    Center for Health Outcomes and Policy Research, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104, USA
    Res Nurs Health 35:566-75. 2012
  5. pmc Changes in hospital nurse work environments and nurse job outcomes: an analysis of panel data
    Ann Kutney-Lee
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, USA
    Int J Nurs Stud 50:195-201. 2013
  6. pmc Nurse staffing, burnout, and health care-associated infection
    Jeannie P Cimiotti
    New Jersey Collaborating Center for Nursing, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
    Am J Infect Control 40:486-90. 2012
  7. pmc Cross-cultural evaluation of the relevance of the HCAHPS survey in five European countries
    Allison Squires
    New York University College of Nursing, New York, NY 10003, USA
    Int J Qual Health Care 24:470-5. 2012
  8. pmc Nursing practice environment and outcomes for oncology nursing
    Jingjing Shang
    School of Nursing, Columbia University, New York, NY 10032, USA
    Cancer Nurs 36:206-12. 2013
  9. ncbi Nurse staffing levels make a difference on patient outcomes: a multisite study in Chinese hospitals
    Xiao Wen Zhu
    Sun Yat sen University School of Nursing, Guangzhou, China
    J Nurs Scholarsh 44:266-73. 2012
  10. pmc Nurse staffing and postsurgical outcomes in black adults
    J Margo Brooks Carthon
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
    J Am Geriatr Soc 60:1078-84. 2012

Scientific Experts

Detail Information

Publications83

  1. pmc Relationship between psychiatric nurse work environments and nurse burnout in acute care general hospitals
    Nancy P Hanrahan
    University of Pennsylvania School of Nursing, Center for Health Outcomes and Policy Research, Philadelphia, Pennsylvania 19104, USA
    Issues Ment Health Nurs 31:198-207. 2010
    ..These results suggest that adjustments in organizational management of inpatient psychiatric environments could have a positive effect on psychiatric nurses' capacity to sustain safe and effective patient care environments...
  2. pmc Lower mortality in magnet hospitals
    Matthew D McHugh
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104 4217, USA
    Med Care 51:382-8. 2013
    ....
  3. pmc Hospital staff nurses' shift length associated with safety and quality of care
    Amy Witkoski Stimpfel
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA
    J Nurs Care Qual 28:122-9. 2013
    ..Extended shift lengths were associated with higher odds of reporting poor quality and safety. Policies aimed at reducing the use of extended shifts may be advisable...
  4. pmc Nurse reported quality of care: a measure of hospital quality
    Matthew D McHugh
    Center for Health Outcomes and Policy Research, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104, USA
    Res Nurs Health 35:566-75. 2012
    ..Nurse reported quality of care is a useful indicator of hospital performance...
  5. pmc Changes in hospital nurse work environments and nurse job outcomes: an analysis of panel data
    Ann Kutney-Lee
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, USA
    Int J Nurs Stud 50:195-201. 2013
    ..Cross-sectional studies have shown that the quality of the nurse work environment is associated with nurse outcomes related to retention, but there have been very few longitudinal studies undertaken to examine this relationship...
  6. pmc Nurse staffing, burnout, and health care-associated infection
    Jeannie P Cimiotti
    New Jersey Collaborating Center for Nursing, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
    Am J Infect Control 40:486-90. 2012
    ..Nurse staffing has been implicated in the spread of infection within hospitals, yet little evidence is available to explain this association...
  7. pmc Cross-cultural evaluation of the relevance of the HCAHPS survey in five European countries
    Allison Squires
    New York University College of Nursing, New York, NY 10003, USA
    Int J Qual Health Care 24:470-5. 2012
    ....
  8. pmc Nursing practice environment and outcomes for oncology nursing
    Jingjing Shang
    School of Nursing, Columbia University, New York, NY 10032, USA
    Cancer Nurs 36:206-12. 2013
    ..It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness...
  9. ncbi Nurse staffing levels make a difference on patient outcomes: a multisite study in Chinese hospitals
    Xiao Wen Zhu
    Sun Yat sen University School of Nursing, Guangzhou, China
    J Nurs Scholarsh 44:266-73. 2012
    ..The purpose of this study is to examine the relationship between nurse staffing and patient outcomes in hospitals in mainland China...
  10. pmc Nurse staffing and postsurgical outcomes in black adults
    J Margo Brooks Carthon
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
    J Am Geriatr Soc 60:1078-84. 2012
    ..To determine the association between nurse staffing and postsurgical outcomes for older black adults, including 30-day mortality and failure to rescue...
  11. pmc Predicting nursing human resources: an exploratory study
    Allison Squires
    New York University College of Nursing
    Policy Polit Nurs Pract 10:101-9. 2009
    ..7; p = .0000). The findings have multiple implications for nursing human resources policy in Mexico and at a global level as governments attempt to build human capital to respond to population health needs...
  12. pmc Nursing care quality and adverse events in US hospitals
    Robert J Lucero
    Center for Evidence Based Practice in the Underserved, Columbia University School of Nursing, 617 West 168th Street, New York, New York 10032, USA
    J Clin Nurs 19:2185-95. 2010
    ..To examine the association between nurses' reports of unmet nursing care needs and their reports of patients' receipt of the wrong medication or dose, nosocomial infections and patient falls with injury in hospitals...
  13. pmc Lower mortality for abdominal aortic aneurysm repair in high-volume hospitals is contingent upon nurse staffing
    Kelly L Wiltse Nicely
    Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA 19104 4217, USA
    Health Serv Res 48:972-91. 2013
    ..To determine whether and to what extent the lower mortality rates for patients undergoing abdominal aortic aneurysm (AAA) repair in high-volume hospitals is explained by better nursing...
  14. pmc The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction
    Amy Witkoski Stimpfel
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
    Health Aff (Millwood) 31:2501-9. 2012
    ..Nursing leaders should also encourage workplace cultures that respect nurses' days off and vacation time, promote nurses' prompt departure at the end of a shift, and allow nurses to refuse to work overtime without retribution...
  15. pmc Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study
    Linda H Aiken
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA Electronic address
    Lancet 383:1824-30. 2014
    ....
  16. pmc Impact of critical care nursing on 30-day mortality of mechanically ventilated older adults
    Deena M Kelly
    1Clinical Research, Investigation and Systems Modeling of Acute Illness CRISMA Center, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 2Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA 3Robert Wood Johnson Foundation Nurse Faculty Scholars, Philadelphia, PA
    Crit Care Med 42:1089-95. 2014
    ....
  17. pmc The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave
    Li Feng Zhang
    School of Nursing, Sun Yat Sen University, Guangzhou, China
    Nurs Outlook 62:128-37. 2014
    ..The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nursing outcomes in Chinese hospitals...
  18. pmc Understanding the role of the professional practice environment on quality of care in Magnet® and non-Magnet hospitals
    Amy Witkoski Stimpfel
    Author Affiliations Assistant Professor Dr Witkoski Stimpfel, College of Nursing, New York University Graduate Student Ms Rosen and The Rosemarie Greco Term Endowed Associate Professorship in Advocacy, Center for Health Outcomes and Policy Research Dr McHugh, School of Nursing, University of Pennsylvania, Philadelphia
    J Nurs Adm 44:10-6. 2014
    ..The aim of this study was to explore the relationship between Magnet Recognition® and nurse-reported quality of care...
  19. pmc The critical care work environment and nurse-reported health care-associated infections
    Deena Kelly
    Deena Kelly is a postdoctoral research fellow in the Clinical Research, Investigation and Systems Modeling of Acute illness
    Am J Crit Care 22:482-8. 2013
    ..The critical care work environment may influence the likelihood of infection in these patients...
  20. pmc Variations in postoperative complications according to race, ethnicity, and sex in older adults
    J Margo Brooks Carthon
    Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania
    J Am Geriatr Soc 61:1499-507. 2013
    ..To explore differences in the incidence of postoperative complications between three racial and ethnic groups (white, black, Hispanic) before and after taking into account potentially confounding patient and hospital characteristics...
  21. pmc Utilization of non-US educated nurses in US hospitals: implications for hospital mortality
    Donna Felber Neff
    University of Florida College of Nursing, Health Professions, Nursing and Pharmacy Complex, PO Box 100187, Gainesville, FL 32610 1087, USA
    Int J Qual Health Care 25:366-72. 2013
    ..To determine whether, and under what circumstance, US hospital employment of non-US-educated nurses is associated with patient outcomes...
  22. pmc An observational study of nurse staffing ratios and hospital readmission among children admitted for common conditions
    Heather L Tubbs-Cooley
    Cincinnati Children s Hospital Medical Center, Cincinnati, Ohio 45229, USA
    BMJ Qual Saf 22:735-42. 2013
    ..We examined the relationship between staffing ratios and all-cause readmission (within 14 days, 15-30 days) among children admitted for common medical and surgical conditions...
  23. pmc An increase in the number of nurses with baccalaureate degrees is linked to lower rates of postsurgery mortality
    Ann Kutney-Lee
    Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA
    Health Aff (Millwood) 32:579-86. 2013
    ..The findings provide support for efforts to increase the production and employment of baccalaureate nurses...
  24. pmc Nursing care and patient outcomes: international evidence
    Robyn B Cheung
    Center for Health Outcomes and Policy Research University of Pennsylvania School of Nursing Philadelphia Estados Unidos
    Enferm Clin 18:35-40. 2008
    ..The Magnet hospital program is one model that has been shown to improve nurse and patient outcomes and is one solution to the shortage of hospital nurses...
  25. pmc Hospital nursing and 30-day readmissions among Medicare patients with heart failure, acute myocardial infarction, and pneumonia
    Matthew D McHugh
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104 4217, USA
    Med Care 51:52-9. 2013
    ..Provisions of the Affordable Care Act that increase hospitals' financial accountability for preventable readmissions have heightened interest in identifying system-level interventions to reduce readmissions...
  26. pmc How differing shift lengths relate to quality outcomes in pediatrics
    Amy Witkoski Stimpfel
    Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA 19104, USA
    J Nurs Adm 43:95-100. 2013
    ....
  27. pmc Hospital use of agency-employed supplemental nurses and patient mortality and failure to rescue
    Linda H Aiken
    School of Nursing, Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA 19104, USA
    Health Serv Res 48:931-48. 2013
    ..To determine the association between the use of agency-employed supplemental registered nurses (SRNs) to staff hospitals and patient mortality and failure to rescue (FTR)...
  28. pmc Quality of care and patient satisfaction in hospitals with high concentrations of black patients
    J Margo Brooks-Carthon
    University of Pennsylvania, Philadelphia, PA 19104, USA
    J Nurs Scholarsh 43:301-10. 2011
    ..To examine the influence of nursing-specifically nurse staffing and the nurse work environment-on quality of care and patient satisfaction in hospitals with varying concentrations of Black patients...
  29. pmc Contradicting fears, California's nurse-to-patient mandate did not reduce the skill level of the nursing workforce in hospitals
    Matthew D McHugh
    Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA, USA
    Health Aff (Millwood) 30:1299-306. 2011
    ..Policy makers in other states can look to California's experience when considering similar approaches to improving patient care...
  30. pmc Nurse specialty certification, inpatient mortality, and failure to rescue
    Deborah Kendall-Gallagher
    University of Texas Health Science Center San Antonio, School of Nursing, Texas, USA
    J Nurs Scholarsh 43:188-94. 2011
    ..To determine if hospital proportion of staff nurses with specialty certification is associated with risk-adjusted inpatient 30-day mortality and failure to rescue (deaths in surgical inpatients following a major complication)...
  31. pmc Importance of work environments on hospital outcomes in nine countries
    Linda H Aiken
    Center for Health Outcomes and Policy Research, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104 4217, USA
    Int J Qual Health Care 23:357-64. 2011
    ..To determine the effect of hospital work environments on hospital outcomes across multiple countries...
  32. pmc Nurses' widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care
    Matthew D McHugh
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, inPhiladelphia, PA, USA
    Health Aff (Millwood) 30:202-10. 2011
    ..Improving nurses' working conditions may improve both nurses' and patients' satisfaction as well as the quality of care...
  33. pmc Lost in translation: student perceptions of cultural competence in undergraduate and graduate nursing curricula
    Danica Fulbright Sumpter
    University of Texas at Austin School of Nursing, TX, USA
    J Prof Nurs 27:43-9. 2011
    ..Student suggestions and recommendations for enhancing cultural competence in the curricula are provided...
  34. pmc Nursing practice environment and registered nurses' job satisfaction in nursing homes
    Jisun Choi
    National Database of Nursing Quality Indicators, School of Nursing, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
    Gerontologist 52:484-92. 2012
    ..The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs in nursing homes. ..
  35. pmc Nurse outcomes in Magnet® and non-magnet hospitals
    Lesly A Kelly
    University of Pennsylvania, Philadelphia, USA
    J Nurs Adm 41:428-33. 2011
    ..05). Magnet hospitals have significantly better work environments than non-Magnet hospitals. The better work environments of Magnet hospitals are associated with lower levels of nurse job dissatisfaction and burnout...
  36. pmc Randomized Clinical Trial of the Effectiveness of a Home-Based Advanced Practice Psychiatric Nurse Intervention: Outcomes for Individuals with Serious Mental Illness and HIV
    Nancy P Hanrahan
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19204 4217, USA
    Nurs Res Pract 2011:840248. 2011
    ..03) from baseline to 12 months. The advanced practice psychiatric nurse intervention is a model of care that holds promise for a higher quality of care and outcomes for this vulnerable population...
  37. pmc Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments
    Linda H Aiken
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, PA 19104 4217, USA
    Med Care 49:1047-53. 2011
    ..Little is known about whether and under what conditions each type of investment works better to improve outcomes...
  38. pmc The effect of hospital electronic health record adoption on nurse-assessed quality of care and patient safety
    Ann Kutney-Lee
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia 19104, USA
    J Nurs Adm 41:466-72. 2011
    ..Our findings suggest that the implementation of a basic EHR may result in improved and more efficient nursing care, better care coordination, and patient safety...
  39. pmc The relationship between hospital work environment and nurse outcomes in Guangdong, China: a nurse questionnaire survey
    Ke Liu
    School of Nursing, Sun Yat Sen University, Guangzhou, China
    J Clin Nurs 21:1476-85. 2012
    ..This study examines the relationship between hospital work environments and job satisfaction, job-related burnout and intention to leave among nurses in Guangdong province, China...
  40. pmc Impact of nurse staffing mandates on safety-net hospitals: lessons from California
    Matthew D McHugh
    University of Pennsylvania School of Nursing, Philadelphia, PA 19104 4217, USA
    Milbank Q 90:160-86. 2012
    ..We examined the differential effect of California's staffing mandate on safety-net and non-safety-net hospitals...
  41. pmc Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States
    Linda H Aiken
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA
    BMJ 344:e1717. 2012
    ..To determine whether hospitals with a good organisation of care (such as improved nurse staffing and work environments) can affect patient care and nurse workforce stability in European countries...
  42. pmc Health care reform and the federal transformation initiatives: capitalizing on the potential of advanced practice psychiatric nurses
    Nancy P Hanrahan
    University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104, USA
    Policy Polit Nurs Pract 11:235-44. 2010
    ..Strategies for facilitating utilization of advanced practice psychiatric nurses discussed...
  43. pmc Risk factors for hospital-acquired 'poor glycemic control': a case-control study
    Matthew D McHugh
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104 4217, USA
    Int J Qual Health Care 23:44-51. 2011
    ....
  44. pmc Effects of nursing practice environments on quality outcomes in nursing homes
    Linda Flynn
    Rutgers College of Nursing, The State University of New Jersey, Newark, New Jersey 07102, USA
    J Am Geriatr Soc 58:2401-6. 2010
    ..Findings indicate that administrative initiatives to create environments that support nursing practice may hold promise for improving quality indicators in nursing homes...
  45. pmc The relationship between inpatient cardiac surgery mortality and nurse numbers and educational level: analysis of administrative data
    Koen Van den Heede
    Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium
    Int J Nurs Stud 46:796-803. 2009
    ..This can obscure relationships between staffing and outcomes at the unit level and lead to invalid inferences...
  46. pmc Nursing: a key to patient satisfaction
    Ann Kutney-Lee
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
    Health Aff (Millwood) 28:w669-77. 2009
    ..Improving nurses' work environments, including nurse staffing, may improve the patient experience and quality of care...
  47. pmc Predictive validity of the International Hospital Outcomes Study questionnaire: an RN4CAST pilot study
    Luk Bruyneel
    Centre for Health Services and Nursing Research, Katholieke Universiteit Leuven, Kapucijnenvoer 35 4, Leuven B 3000, Belgium
    J Nurs Scholarsh 41:202-10. 2009
    ....
  48. pmc Variations in nursing care quality across hospitals
    Robert J Lucero
    Center for Evidence Based Practice in the Underserved, Columbia University, New York, USA
    J Adv Nurs 65:2299-310. 2009
    ..Variations in nursing care quality across hospitals...
  49. pmc Implications of the California nurse staffing mandate for other states
    Linda H Aiken
    Center for Health Outcomes and Policy Research, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104 4217, USA
    Health Serv Res 45:904-21. 2010
    ....
  50. pmc Hospital characteristics, clinical severity, and outcomes for surgical oncology patients
    Christopher R Friese
    Division of Nursing Business and Health Systems, School of Nursing, University of Michigan, Ann Arbor, MI 48109 5482, USA
    Surgery 147:602-9. 2010
    ..Our objective was to determine whether differences in outcomes explained by hospital structural characteristics are mitigated by differences in patient severity...
  51. pmc The effect of work hours on adverse events and errors in health care
    Danielle M Olds
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, USA
    J Safety Res 41:153-62. 2010
    ..We studied the relationship between registered nurses' extended work duration with adverse events and errors, including needlestick injuries, work-related injuries, patient falls with injury, nosocomial infections, and medication errors...
  52. pmc National Cancer Institute Cancer Center designation and 30-day mortality for hospitalized, immunocompromised cancer patients
    Christopher R Friese
    University of Michigan School of Nursing, Ann Arbor, USA
    Cancer Invest 28:751-7. 2010
    ..To examine 30-day mortality and National Cancer Institute (NCI) designation for cancer patients who are immunocompromised and hospitalized...
  53. pmc Adverse events associated with organizational factors of general hospital inpatient psychiatric care environments
    Nancy P Hanrahan
    Center for Health Outcomes and Policy Research, University of Pennsylvania, School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
    Psychiatr Serv 61:569-74. 2010
    ..The events examined were wrong medication, patient falls with injuries, complaints from patients and families, work-related staff injuries, and verbal abuse directed toward nurses...
  54. pmc Understanding clinical expertise: nurse education, experience, and the hospital context
    Matthew D McHugh
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104 4217, USA
    Res Nurs Health 33:276-87. 2010
    ..Our findings suggest that, controlling for individual characteristics, the hospital context significantly influences clinical nursing expertise...
  55. pmc Nurse burnout and quality of care: cross-national investigation in six countries
    Lusine Poghosyan
    Bouve College of Health Sciences, School of Nursing, Northeastern University, 407C Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 5000, USA
    Res Nurs Health 33:288-98. 2010
    ..These findings suggest that reducing nurse burnout may be an effective strategy for improving nurse-rated quality of care in hospitals...
  56. ncbi Effects of hospital care environment on patient mortality and nurse outcomes
    Linda H Aiken
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania 19104 6096, USA
    J Nurs Adm 39:S45-51. 2009
    ..CONCLUSION: Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care...
  57. ncbi New Zealand nurses' reports on hospital care: an international comparison
    Mary Finlayson
    University of Auckland, New Zealand
    Nurs Prax N Z 23:17-28. 2007
    ..The implications of these findings are discussed in light of recent changes in the hospital environment...
  58. pmc Rationing of nursing care and its relationship to patient outcomes: the Swiss extension of the International Hospital Outcomes Study
    Maria Schubert
    Institute of Nursing Science, University of Basel, Bernoullistrasse 28, CH 4056 Basel, Switzerland
    Int J Qual Health Care 20:227-37. 2008
    ..Rationing was measured using the newly developed Basel Extent of Rationing of Nursing Care (BERNCA) instrument. Additional data were collected using an adapted version of the International Hospital Outcomes Study questionnaire...
  59. pmc Hospital nurse practice environments and outcomes for surgical oncology patients
    Christopher R Friese
    Dana Farber Cancer Institute, Harvard School of Public Health, 44 Binney Street SM 271, Boston, MA 02115, USA
    Health Serv Res 43:1145-63. 2008
    ..To examine the effect of nursing practice environments on outcomes of hospitalized cancer patients undergoing surgery...
  60. pmc The U.S. presidential election and health care workforce policy
    Matthew D McHugh
    University of Pennsylvania, Philadelphia, USA
    Policy Polit Nurs Pract 9:6-14. 2008
    ..Three general themes are highlighted for their implications on the physician and nurse workforce supply, including (a) expansion of health care coverage, (b) workforce investment, and (c) cost control and quality improvement...
  61. pmc Supplemental nurse staffing in hospitals and quality of care
    Linda H Aiken
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania 19104 6096, USA
    J Nurs Adm 37:335-42. 2007
    ..To promote evidence-based decision making regarding hospital staffing, the authors examined the characteristics of supplemental nurses, as well as the relationship of supplemental staff to nurse outcomes and adverse events...
  62. ncbi Hospital work environments, nurse characteristics, and sharps injuries
    Sean P Clarke
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104 6096, USA
    Am J Infect Control 35:302-9. 2007
    ..A growing body of research links working conditions, such as staffing levels and work environment characteristics, with safety for both patients and workers in health care settings, including sharps injuries in hospital staff nurses...
  63. ncbi Sharp-device injuries to hospital staff nurses in 4 countries
    Sean P Clarke
    Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA, 19104, USA
    Infect Control Hosp Epidemiol 28:473-8. 2007
    ..To compare sharp-device injury rates among hospital staff nurses in 4 Western countries...
  64. pmc Outcomes of variation in hospital nurse staffing in English hospitals: cross-sectional analysis of survey data and discharge records
    Anne Marie Rafferty
    Florence Nightingale School of Nursing and Midwifery, King s College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
    Int J Nurs Stud 44:175-82. 2007
    ..Despite growing evidence in the US, little evidence has been available to evaluate whether internationally, hospitals in which nurses care for fewer patients have better outcomes in terms of patient survival and nurse retention...
  65. ncbi Variations in nursing practice environments: relation to staffing and hospital characteristics
    Eileen T Lake
    Department of Sociology, University of Pennsylvania, Philadelphia, PA 19104 6096, USA
    Nurs Res 55:1-9. 2006
    ..While improvements in nursing practice environments are considered essential to address the nursing shortage, relatively little is known about the nursing practice environments in most hospitals...
  66. pmc Multilevel modeling of a clustered continuous outcome: nurses' work hours and burnout
    Sunhee Park
    School of Nursing, University of Pennsylvania, 420 Guardian Drive, Philadelphia, PA 19104, USA
    Nurs Res 54:406-13. 2005
    ..Multilevel models were designed to analyze data generated from a nested structure (e.g., nurses within hospitals) because conventional linear regression models underestimate standard errors and, in turn, overestimate test statistics...
  67. ncbi The impact of hospital nursing characteristics on 30-day mortality
    Carole A Estabrooks
    Knowledge Utilization Studies Program, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
    Nurs Res 54:74-84. 2005
    ..Less attention has been given to other hospital nursing characteristics central to optimal professional practice, namely nurse education and skill mix, continuity of care, and quality of the work environment...
  68. pmc Effects of hospital care environment on patient mortality and nurse outcomes
    Linda H Aiken
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania 19104 6096, USA
    J Nurs Adm 38:223-9. 2008
    ..The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education...
  69. pmc Economics of nursing
    Linda H Aiken
    Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA, USA
    Policy Polit Nurs Pract 9:73-9. 2008
    ....
  70. pmc [Studies enhance evidence and knowledge]
    Maria Schubert
    Instituts für Pflegewissenschaft der Universität, Basel
    Krankenpfl Soins Infirm 101:24-5, 56-7, 70-1. 2008
  71. pmc Factor structure of the Maslach burnout inventory: an analysis of data from large scale cross-sectional surveys of nurses from eight countries
    Lusine Poghosyan
    Bouve College of Health Sciences, School of Nursing and School of Health Professions Masters of Public Health MPH, Northeastern University, 103 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 5000, USA
    Int J Nurs Stud 46:894-902. 2009
    ..Job burnout is an important predictor of nurse retention. Reliable and valid measures are required to monitor this phenomenon internationally...
  72. pmc Competence and certification of registered nurses and safety of patients in intensive care units
    Deborah Kendall-Gallagher
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104 6096, USA
    Am J Crit Care 18:106-13; quiz 114. 2009
    ..The relationship between specialty certification and clinical competence of registered nurses and safety of patients is a relatively new area of inquiry in nursing...
  73. pmc Development of the Hospital Nurse Surveillance Capacity Profile
    Ann Kutney-Lee
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104 4217, USA
    Res Nurs Health 32:217-28. 2009
    ..Greater nurse surveillance capacity was significantly associated with better quality of care and fewer adverse events. The profile may assist administrators to improve nurse surveillance and patient outcomes...
  74. pmc Transformative impact of Magnet designation: England case study
    Linda H Aiken
    Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA 19104 6096, USA
    J Clin Nurs 17:3330-7. 2008
    ..To test the impact of the implementation of Magnet principles of improving nurses' work environments...
  75. pmc Poor work environments and nurse inexperience are associated with burnout, job dissatisfaction and quality deficits in Japanese hospitals
    Masako Kanai-Pak
    University of Arizona, Tucson, AZ, USA
    J Clin Nurs 17:3324-9. 2008
    ..To describe nurse burnout, job dissatisfaction and quality of care in Japanese hospitals and to determine how these outcomes are associated with work environment factors...
  76. pmc An international hospital outcomes research agenda focused on nursing: lessons from a decade of collaboration
    Sean P Clarke
    Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA 19104 6096, USA
    J Clin Nurs 17:3317-23. 2008
    ..To describe the origins, design and outcomes of an international hospital outcomes collaboration focused on nursing issues...
  77. pmc Solving nursing shortages: a common priority
    James Buchan
    Queen Margaret University, Queen Margaret University Drive, Edinburgh, UK
    J Clin Nurs 17:3262-8. 2008
    ..This paper provides a context for this special edition. It highlights the scale of the challenge of nursing shortages, but also makes the point that there is a policy agenda that provides workable solutions...
  78. pmc Effect of nurse staffing and education on the outcomes of surgical patients with comorbid serious mental illness
    Ann Kutney-Lee
    Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, 418 Curie Blvd, 3R NEB, Philadelphia, PA 19104 6096, USA
    Psychiatr Serv 59:1466-9. 2008
    ....
  79. pmc Failure to rescue in the surgical oncology population: implications for nursing and quality improvement
    Christopher R Friese
    School of Nursing, University of Michigan, Ann Arbor, USA at
    Oncol Nurs Forum 35:779-85. 2008
    ..To analyze the frequency, type, and correlates of postoperative complications for surgical patients with cancer to illustrate practical application of the failure to rescue concept in oncology nursing practice...
  80. pmc Nurse staffing and patient outcomes in Belgian acute hospitals: cross-sectional analysis of administrative data
    Koen Van den Heede
    Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Kapucijnenvoer 35 4, Leuven B 3000, Belgium
    Int J Nurs Stud 46:928-39. 2009
    ..Studies have linked nurse staffing levels (number and skill mix) to several nurse-sensitive patient outcomes. However, evidence from European countries has been limited...
  81. pmc Psychiatric nurse reports on the quality of psychiatric care in general hospitals
    Nancy P Hanrahan
    Center for Health Outcomes and Policy Research, Leonard David Institute of Health Economics, University of Pennsylvania School of Nursing, Philadelphia 19104, USA
    Qual Manag Health Care 17:210-7. 2008
    ..Collectively, the results from this study underscore the organizational problems and quality-of-care issues that cause psychiatric nurses in general hospital settings to evaluate their work environments negatively...
  82. ncbi The relationship between UK hospital nurse staffing and emotional exhaustion and job dissatisfaction
    Louisa Sheward
    University of Paisley
    J Nurs Manag 13:51-60. 2005
    ..To explore the relationship between nurse outcomes (dissatisfaction and emotional exhaustion) and nurse workload, nurse characteristics and hospital variables...