1. Sofer, Dalia

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A recent study of 18,142 patients admitted to 49 hospitals in Alberta, Canada, with diagnoses of acute myocardial infarction, congestive heart failure, chronic obstructive pulmonary disease, pneumonia, or stroke, revealed that 30-day mortality rates are affected by many factors, such as the education level, skill mix, employment status, and work satisfaction of the nursing staff, along with the relationship between nurses and physicians.


The study found that hospitals with lower 30-day mortality rates had a nursing staff with higher education levels, a higher ratio of RNs to non-RN nursing staff, and more collaborative nurse-physician relationships. Hospitals with more casual or temporary nurses had higher mortality rates. Other factors in their analysis that the researchers found relevant but not statistically significant included the nurses' perception of staffing levels, unmet patient care needs, and time spent on nonnursing tasks.


The authors recommend that hospital administrators and policymakers pay more attention to the work environment in health care institutions in order to improve patient and system outcomes.


Estabrooks C, et al. Nurs Res 2005;54(2): 74-84.

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