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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 6 of 6 Research Studies DisplayedSimpson KR, Spetz J, Gay CL
Hospital characteristics associated with nurse staffing during labor and birth: Inequities for the most vulnerable maternity patients.
The objective of this study was to estimate the relationship between hospital characteristics and adherence with Association of Women's Health, Obstetric and Neonatal Nurses nurse staffing guidelines. Registered nurses were enrolled in a cross-sectional survey; hospital characteristics were obtained from the 2018 American Hospital Association Annual Survey. The findings indicated that, overall, nurses reported strong adherence to staffing guidelines within their hospitals. Higher birth volume, teaching status, higher percentage of Medicaid-paid births, and presence of a neonatal intensive care unit were all associated with lower mean adherence scores.
AHRQ-funded; HS025715.
Citation: Simpson KR, Spetz J, Gay CL .
Hospital characteristics associated with nurse staffing during labor and birth: Inequities for the most vulnerable maternity patients.
Nurs Outlook 2023 May; 71(3):101960. doi: 10.1016/j.outlook.2023.101960..
Keywords: Hospitals, Maternal Care, Provider: Nurse, Workforce, Vulnerable Populations
Dierkes AM, Aiken LH, Sloane DM
Hospital nurse staffing and sepsis protocol compliance and outcomes among patients with sepsis in the USA: a multistate cross-sectional analysis.
The timely and effective administration of sepsis treatment may improve sepsis outcomes, and those improvements may provide evidence of the need for mandated reporting of adherence to sepsis care protocol. The purpose of the study was to better understand the association between patient-to-nurse staffing ratios, sepsis protocol compliance, and patient outcomes. The researchers conducted a cross-sectional study utilizing linked data from 537 hospitals from across California, Florida, Illinois, Pennsylvania, New Jersey, and New York (representing 252,699 Medicare inpatients with sepsis present on admission), nurse and hospital surveys, and Centers for Medicare and Medicaid Services Hospital Compare and the corresponding MedPAR patient claims. The study found that every additional patient per nurse was associated with greater odds of mortality, readmission, ICU admission, and greater risk of relative duration of stay. Every 10% increase in compliance of sepsis protocol was only associated with a shorter duration of stay. The study concluded that improvements in nurse staffing and the nurse-to-patient ratios had a greater impact on sepsis infection outcomes than compliance with protocols.
AHRQ-funded; HS026232.
Citation: Dierkes AM, Aiken LH, Sloane DM .
Hospital nurse staffing and sepsis protocol compliance and outcomes among patients with sepsis in the USA: a multistate cross-sectional analysis.
BMJ Open 2022 Mar 22;12(3):e056802. doi: 10.1136/bmjopen-2021-056802..
Keywords: Sepsis, Hospitals, Provider: Nurse, Workforce
Germack HD, Kandrack R, Martsolf GR
Relationship between rural hospital closures and the supply of nurse practitioners and certified registered nurse anesthetists.
This study sought to examine the extent to which rural hospital closures are associated with changes in the NP (nurse practitioner) and CRNA (certified registered nurse anesthetist) workforce. The authors used the Area Health Resources Files (AHRF) data from 2010-2017 to estimate the relationship between rural hospital closures and changes in the supply of NPs and CRNAs. They found 151 hospital closures among 1,544 rural counties. After controlling for local market characteristics, they did not find a significant relationship between hospital closure and the supply of NPs and CRNAs.
AHRQ-funded; HS000032.
Citation: Germack HD, Kandrack R, Martsolf GR .
Relationship between rural hospital closures and the supply of nurse practitioners and certified registered nurse anesthetists.
Nurs Outlook 2021 Nov-Dec;69(6):945-52. doi: 10.1016/j.outlook.2021.05.005..
Keywords: Provider: Nurse, Workforce, Hospitals
Cohen C, Baird M, Koirola N
The surgical and anesthesia workforce and provision of surgical services in rural communities: a mixed-methods examination.
This mixed-methods study described the distribution of the surgical and anesthesia workforce and qualitatively explored how such workforce and other factors influenced rural hospitals' provision of surgical services. Using American Hospital Association survey data, the researchers found that within rural counties, 55.1% had no surgeon, 81.2% had no anesthesiologist, and 58.1% had no Certified Registered Nurse Anesthetist. While rural hospitals reported meeting community needs for elective and noncomplex surgeries, these hospitals continued to face significant challenges providing subspecialty surgeries, emergency surgeries, and 24-hour obstetrical services.
AHRQ-funded; HS023009.
Citation: Cohen C, Baird M, Koirola N .
The surgical and anesthesia workforce and provision of surgical services in rural communities: a mixed-methods examination.
J Rural Health 2021 Jan;37(1):45-54. doi: 10.1111/jrh.12417..
Keywords: Rural Health, Access to Care, Surgery, Workforce, Provider: Physician, Provider: Nurse, Provider, Hospitals
Kelly LA, McHugh MD, Aiken LH
Nurse Outcomes in Magnet(R) and non-magnet hospitals.
The goal of this study was to determine whether work environments, staffing, and nurse outcomes differ between Magnet and non-Magnet hospitals. Results demonstrated superior nurse work environments in Magnet hospitals compared with non-Magnet hospitals, with better work environments being associated with lower nurse job dissatisfaction and burnout. Three decades of evidence showing superior outcomes for Magnet hospitals place this organizational innovation into a class all of its own as best practice, deserving the attention of hospital leaders, nurses, and the public.
AHRQ-funded; HS017551.
Citation: Kelly LA, McHugh MD, Aiken LH .
Nurse Outcomes in Magnet(R) and non-magnet hospitals.
J Nurs Adm 2019 Oct;49(10S Suppl):S19-s24. doi: 10.1097/nna.0000000000000801..
Keywords: Burnout, Hospitals, Provider, Provider: Nurse, Workforce
de Cordova PB, Rogowski J, Riman KA
Effects of public reporting legislation of nurse staffing: a trend analysis.
The authors examined nurse staffing trends after the New Jersey enactment of P.L.1971, c.136 (C.26:2 H-13) on January 24, 2005, mandating that all health care facilities compile, post, and report staffing information. They found that the number of patients per registered nurse decreased for ten specialties, and conclude that this indicates the importance of public reporting in improving patient safety.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Rogowski J, Riman KA .
Effects of public reporting legislation of nurse staffing: a trend analysis.
Policy Polit Nurs Pract 2019 May;20(2):92-104. doi: 10.1177/1527154419832112..
Keywords: Hospitals, Patient Safety, Workforce, Policy, Provider, Provider: Nurse