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Improving working conditions for nurses also promotes patient safety, new research suggests. Researchers conducted an observational study using data from the National Nosocomial Infection Surveillance system protocols and Medicare files. They measured working conditions by surveying 1,095 nurses about the climate of their organization. Researchers also collected data on staffing numbers, overtime hours, and wages. Outcome measures included central-line-associated bloodstream infections, ventilator-associated pneumonia, catheter-associated urinary tract infections, 30-day mortality, and pressure ulcers. The sample comprised 15,846 patients in 51 adult intensive care units in 31 hospitals.
Nursing units with higher staffing had a lower incidence of central-line-associated bloodstream infections, ventilator-associated pneumonia, 30-day mortality, and pressure ulcers. Increased overtime was associated with higher rates of catheter-associated urinary tract infections and ulcers, but slightly lower rates of central-line-associated bloodstream infections. Nurse wages weren't associated with any of the outcomes.
The researchers conclude that "improving nurse working conditions can improve patient safety. Substitutes for overtime, such as availability of increased qualified float nurses through cross-training, should be explored to meet fluctuating staffing needs."
Stone PW, et al., Nurse working conditions and patient safety outcomes, Medical Care, June 2007.
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