We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Development and use of an adjusted nurse staffing metric in the neonatal intensive care unit.
- Authors
Tawfik, Daniel S.; Profit, Jochen; Lake, Eileen T.; Liu, Jessica B.; Sanders, Lee M.; Phibbs, Ciaran S.
- Abstract
<bold>Objective: </bold>To develop a nurse staffing prediction model and evaluate deviation from predicted nurse staffing as a contributor to patient outcomes.<bold>Data Sources: </bold>Secondary data collection conducted 2017-2018, using the California Office of Statewide Health Planning and Development and the California Perinatal Quality Care Collaborative databases. We included 276 054 infants born 2008-2016 and cared for in 99 California neonatal intensive care units (NICUs).<bold>Study Design: </bold>Repeated-measures observational study. We developed a nurse staffing prediction model using machine learning and hierarchical linear regression and then quantified deviation from predicted nurse staffing in relation to health care-associated infections, length of stay, and mortality using hierarchical logistic and linear regression.<bold>Data Collection Methods: </bold>We linked NICU-level nurse staffing and organizational data to patient-level risk factors and outcomes using unique identifiers for NICUs and patients.<bold>Principal Findings: </bold>An 11-factor prediction model explained 35 percent of the nurse staffing variation among NICUs. Higher-than-predicted nurse staffing was associated with decreased risk-adjusted odds of health care-associated infection (OR: 0.79, 95% CI: 0.63-0.98), but not with length of stay or mortality.<bold>Conclusions: </bold>Organizational and patient factors explain much of the variation in nurse staffing. Higher-than-predicted nurse staffing was associated with fewer infections. Prospective studies are needed to determine causality and to quantify the impact of staffing reforms on health outcomes.
- Subjects
CALIFORNIA; INTENSIVE care units; NEONATAL intensive care; NURSE-patient ratio; NEONATAL intensive care units; CROSS infection; NURSES; HEALTH care reform; WORKING hour statistics; MEDICAL quality control; RESEARCH; RESEARCH methodology; EVALUATION research; MEDICAL cooperation; COMPARATIVE studies; HOSPITAL nursing staff; EMPLOYEES' workload; RESEARCH funding; WORKING hours; LONGITUDINAL method
- Publication
Health Services Research, 2020, Vol 55, Issue 2, p190
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.13249