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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 4 of 4 Research Studies DisplayedMerkow RP, Chung JW, Slota JM
Correlation of the US News and World Report-calculated nurse staffing index with actual hospital-reported nurse staffing.
This study’s objective was to understand how the Nurse Staffing Index (NSI) used in the US News and World Report “Best Hospitals” rankings correlates to actual nurse staffing levels. Nurse staffing data was obtained from publicly available data in the states of Illinois, California, and New Jersey. No other states had publicly accessible data. Hospital characteristics were obtained from the 2016 American Hospital Association (AHA) survey. The NSI was calculated using AHA data and is defined as the number of FTE RNs per adjusted patient day. Hospital characteristics were assessed using Hospital Compare data. Higher actual hospital-reported nurse staffing in Illinois and New Jersey was paradoxically associated with lower nurse staffing when measured by the NSI. California hospital-reported staffing intensity was weakly correctly with the NSI and RN nursing hours per patient day was not correlated with any of the 9 structural measures of hospital quality, while NSI was positively correlated with 3 of the 9 measures, particularly hospital volume status. None of the 11 outcome measures the authors assessed were associated with RN nursing hours per patient day or the NSI in either Illinois or California. All 12 patient experience measures were significantly and positively correlated with RN nursing hours in Illinois. However, none of the patient experience measures were significantly associated with the NSI in Illinois. The authors concluded that the NSI may not measure actual nurse staffing as intended.
AHRQ-funded; HS024516; HS026385.
Citation: Merkow RP, Chung JW, Slota JM .
Correlation of the US News and World Report-calculated nurse staffing index with actual hospital-reported nurse staffing.
J Nurs Care Qual 2022 Jul-Sep;37(3):195-98. doi: 10.1097/ncq.0000000000000619..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Provider: Nurse, Workforce
Cimiotti JP, Becker ER, Li Y
Association of registered nurse staffing with mortality risk of Medicare beneficiaries hospitalized with sepsis.
The purpose of this cross-sectional study was to determine if registered nurse workload was related with mortality in Medicare beneficiaries admitted to an acute care hospital with sepsis. The researchers evaluated the records of Medicare beneficiaries ages 65 to 99 years with a primary diagnosis of sepsis that was present on admission to 1 of 1958 nonfederal, general acute care hospitals that had data on CMS SEP-1 scores and registered nurse workload. Researchers utilized 2018 data from the American Hospital Association Annual Survey, CMS Hospital Compare, and Medicare claims. The patient outcome of interest was mortality within 60 days of admission. The study found that 702,140 Medicare beneficiaries with a mean age of 78.2 years, 51% of whom were women, had a diagnosis of sepsis. In a multivariable regression model, each additional registered nurse hour per patient day (HPPD) was associated with a 3% decrease in the odds of 60-day mortality. The researchers concluded that hospitals which provide more registered nurse hours of care could possibly decrease the likelihood of mortality in Medicare beneficiaries with sepsis.
AHRQ-funded; HS026232.
Citation: Cimiotti JP, Becker ER, Li Y .
Association of registered nurse staffing with mortality risk of Medicare beneficiaries hospitalized with sepsis.
JAMA Health Forum 2022 May;3(5):e221173. doi: 10.1001/jamahealthforum.2022.1173..
Keywords: Sepsis, Mortality, Provider: Nurse, Nursing, Workforce
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
Womack DM, Hribar MR, Steege LM
Registered nurse strain detection using ambient data: an exploratory study of underutilized operational data streams in the hospital workplace.
Registered nurses (RNs) regularly adapt their work to ever-changing situations but routine adaptation transforms into RN strain when service demand exceeds staff capacity and patients are at risk of missed or delayed care. The purpose of this study was to assess the utility of ambient workplace data, defined as time-stamped transaction records and log file data produced by non-electronic health record care delivery tools (e.g., nurse call systems, communication devices), as an information channel for automated sensing of RN strain.
AHRQ-funded; HS026370.
Citation: Womack DM, Hribar MR, Steege LM .
Registered nurse strain detection using ambient data: an exploratory study of underutilized operational data streams in the hospital workplace.
Appl Clin Inform 2020 Aug;11(4):598-605. doi: 10.1055/s-0040-1715829..
Keywords: Provider: Nurse, Provider, Health Information Technology (HIT), Workforce, Burnout