Tuesday, 10 March 2015

Staffing models and nursing outcomes

Roger Watson, Editor-in-Chief

Does the ratio of different types of nurses make any difference to patient outcomes? It seems that in some cases it does and not always how you would expect. A study in ICU from Taiwan by Yang et al. (2015) titled 'The impact of three nursing staffing models on nursing outcomes' and published in JAN addresses this by looking at three different models with different percentages of Registered Nurses (RN) to nurse aides and with different ratios of graduate and ICU trained nurses.

Unexpectedly, the model with 100% RNs was the one where most medication errors were made. It appears that where RNs are responsible for checking medications and also administering them that more mistakes are made than when they simply check the medication and a nurses aide administers. Otherwise, a higher percentage of RNs had a positive impact on urinary tract infections, rate of bloodstream infections and ventilator weaning. The lower percentage RN groups incurred higher nursing costs.

The authors conclude: 'These findings suggest that use of different skill mix models that substitute nurse aides for RNs impact nursing care activities and quality of care' and 'we suggest that hospitals employ and train their own nurse aides and develop a training system and education materials for RNs and nurse aides to maintain patient safety and improve quality of care.

You can also listen to this post as a podcast.


Yang P-H, Hung C-H, Chen Y-C (2015) The impact of three nursing staffing models on nursing outcomes Journal of Advanced Nursing doi: 10 1111/jan.12643

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