The Relationship of Nursing Workforce Characteristics to Patient Outcomes

Abstract

Three reports from the Institute of Medicine found that errors in hospital care were more common than previously thought; that health care delivery should be reorganized to improve the quality of care; and that, operationally, nurses have a critical role in securing patient safety. Now the contribution of nursing to the reduction of adverse events must be established empirically, so that nursing-sensitive indicators can be incorporated in such health care-improvement strategies as public reporting of hospital quality and performance-based payment systems. This article reviews what is known from previous nursing outcomes research and identifies gaps in the current state of knowledge. It then describes the contribution to research that can be made through the National Database of Nursing Quality Indicators TM (NDNQI®). Next it reports an NDNQI study that found three nursing workforce characteristics to be related significantly to patient outcomes: total nursing hours per patient day, percentage of hours supplied by RNs, and years of experience in nursing, and concludes with a discussion of the implications of these findings for both for nursing administrators and outcomes-based, quality-improvement initiatives.