Title

Measures Of Nurse Staffing: Should We Account For Patient Turnover?

Keywords

Length of stay; Patient throughput; RN staffing

Abstract

Objective. To assess the difference in nurse staffing using measures that adjust for patient turnover and severity versus those that do not. Data Sources. Numbers of registered nurses (RNs), adjusted patient days of care (APDC), length of stay, and patient severity information from acute-care general hospitals in Pennsylvania 1994-2001, obtained from the Pennsylvania Department of Health, the American Hospital Association, and the Atlas MediQual system. Study Design. After examining the trends in patient turnover and severity and their relationship to RN staffing, we apply two patient turnover indices with and without patient acuity adjustments to RN staffing measures, and test the difference between the original and adjusted measures using paired sample t-tests. Data Extraction Methods. Data sets were match-merged by hospital ID, and patient turnover and severity indices were created, using 1994 as the base year. RN staffing measures were developed using unadjusted APDC and APDC adjusted for patient turnover and both patient turnover and severity. Principal Findings. Patient turnover increased significantly from 1994 to 2001. The difference between RN staffing measures adjusted for patient turnover and severity and those not adjusted was increasingly significant from 1999 on. Unadjusted RN staffing showed a 1 percent decline over the eight year period compared to decreases of from 10 to 26 percent after adjustments. Conclusions. These results indicate that the assessment of unadjusted RN staffing by RN to patient ratios alone significantly underestimates nursing needs and overstates RN staffing levels. Patient turnover, as well as acuity, should be taken into account in staffing assessment and decision-making.

Publication Date

1-1-2005

Publication Title

Academy of Management 2005 Annual Meeting: A New Vision of Management in the 21st Century, AOM 2005

Document Type

Article; Proceedings Paper

Personal Identifier

scopus

DOI Link

https://doi.org/10.5465/ambpp.2005.18778673

Socpus ID

85087223390 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/85087223390

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