West, Elizabeth (2007) The impact of the nursing workforce on patient outcomes in intensive care. In: The 2007 International Nursing Research Conference, 1-4 May 2007, University of Dundee, Scotland.

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Abstract

Introduction: Evidence from studies conducted mainly in the US and mainland Europe suggests that characteristics of the workforce, such as nurse patient ratios and workload (measured in a number of different ways) may be linked to variations in patient outcomes across health care settings (Carmel and Rowan 2001). Few studies have tested this relationship in the UK thus questions remain about whether we are justified in extrapolating evidence from studies conducted in very different health care systems.

Objectives: To investigate whether characteristics of the nursing workforce affect patient mortality UK Intensive Care Units.

Data: Patient data came from the case mix programme, Intensive Care National Audit and Research Centre (ICNARC), while information about the units came from a survey of all ICUs in England (Audit Comission 1998). The merged data set contained information on 43,859 patients in 69 units across England. ICNARC also supplied a risk adjustment variable to control for patient characteristics that are often the most important determinants of survival.

Methods: Multivariate multilevel logistic regression.

Findings: Higher numbers of direct care nurses and lower scores on measures of workload(proportion of occupied beds at the time the patient was admitted and mean daily transfers into the unit) were associated with lower mortality rates. Furthermore, the effect of the number of direct care nurses was greatest on the life chances of the patients who were most at risk of dying.

Implications: This study has wide implications for workforce policy and planning because it shows that the size of the nursing workforce is associated with mortality (West et al 2006). Few studies have demonstrated this relationship in the UK. This study has a number of strengths and weaknesses and further research is required to determine whether this relationship between the nursing workforce and patient outcomes is causal.

Item Type:	Conference or Conference Paper (Paper)
Additional Information:	[1] This paper was first presented at the 2007 International Nursing Research Conference organized by the Royal College of Nursing of the United Kingdom Research Society. It was held at the University of Dundee, Scotland from 1-4 May 2007. The paper was given within Concurrent Session 2, 2.8 Theme: Outcomes with the number 2.8.2., on 1st May 2007. [1] An abstract of this paper was published on p.48 of the Royal College of Nursing of the United Kingdom Research Society, The 2007 International Nursing Research Conference Book of Abstracts, produced by RCN Events, ISBN: 9781904114420.
Uncontrolled Keywords:	nursing workforce, impact, patient outcomes, intensive care
Subjects:	R Medicine > RT Nursing
Pre-2014 Departments:	School of Health & Social Care School of Health & Social Care > Nursing Research Group
Related URLs:	Organisation Organisation Organisation Organisation
Last Modified:	14 Oct 2016 09:07
URI:	http://gala.gre.ac.uk/id/eprint/2614

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