Nurses' Work Schedule Characteristics, Nurse Staffing, and Patient Mortality

• DOI: 10.1097/nnr.0b013e3181fff15d
• Publication Date: 2010-12-02T10:06:56Z
• Authors: Alison M. Trinkoff; Meg Johantgen; Carla L. Storr; Ayse P. Gurses; Yulan Liang; Kihye Han
• Keywords: Staffing; Acute care

Background: Although nurse staffing has been found to be related patient mortality, there limited study of the independent effect work schedules on care outcomes. Objective: To determine if, in hospitals where nurses report more adverse schedules, would increased controlling for staffing. Methods: A cross-sectional design was used, with multilevel data from a 2004 survey 633 working 71 acute nonfederal North Carolina and Illinois. Mortality measures were risk-adjusted Agency Healthcare Research Quality Inpatient Indicators, American Hospital Association Annual Survey hospitals. Principal components analysis conducted 12 schedule items create eight components. Generalized estimating equations used examine hypothesis. Results: Work significantly mortality when levels hospital characteristics controlled. Pneumonia deaths likely reported long hours (odds ratio [OR] = 1.42, 95% confidence interval [CI] 1.17-1.73, p < .01) lack time away (OR 1.24, CI 1.03-1.50, .05). Abdominal aortic aneurysm also associated 1.39, 1.11-1.73, .01). For patients congestive heart failure, while sick 1.13-1.72, .01), whereas myocardial infarction weekly burden (hours per week; days row) 1.33, 1.09-1.63, Discussion: In addition staffing, nurses' are mortality. This suggests that an