Nurse staffing and patient outcomes in Belgian acute hospitals: Cross-sectional analysis of administrative data

Koen Van den Heede, Walter Sermeus, Luwis Diya, Sean Clarke, Emmanuel Lesaffre, Arthur Vleugels, Linda H. Aiken

Research output: Contribution to journalArticle

Abstract

Background: Studies have linked nurse staffing levels (number and skill mix) to several nurse-sensitive patient outcomes. However, evidence from European countries has been limited. Objectives: This study examines the association between nurse staffing levels (i.e. acuity-adjusted Nursing Hours per Patient Day, the proportion of registered nurses with a Bachelor's degree) and 10 different patient outcomes potentially sensitive to nursing care. Design-setting-participants: Cross-sectional analyses of linked data from the Belgian Nursing Minimum Dataset (general acute care and intensive care nursing units: n = 1403) and Belgian Hospital Discharge Dataset (general, orthopedic and vascular surgery patients: n = 260,923) of the year 2003 from all acute hospitals (n = 115). Methods: Logistic regression analyses, estimated by using a Generalized Estimation Equation Model, were used to study the association between nurse staffing and patient outcomes. Results: The mean acuity-adjusted Nursing Hours per Patient Day in Belgian hospitals was 2.62 (S.D. = 0.29). The variability in patient outcome rates between hospitals is considerable. The inter-quartile ranges for the 10 patient outcomes go from 0.35 for Deep Venous Thrombosis to 3.77 for failure-to-rescue. No significant association was found between the acuity-adjusted Nursing Hours per Patient Day, proportion of registered nurses with a Bachelor's degree and the selected patient outcomes. Conclusion: The absence of associations between hospital-level nurse staffing measures and patient outcomes should not be inferred as implying that nurse staffing does not have an impact on patient outcomes in Belgian hospitals. To better understand the dynamics of the nurse staffing and patient outcomes relationship in acute hospitals, further analyses (i.e. nursing unit level analyses) of these and other outcomes are recommended, in addition to inclusion of other study variables, including data about nursing practice environments in hospitals.

Original languageEnglish (US)
Pages (from-to)928-939
Number of pages12
JournalInternational Journal of Nursing Studies
Volume46
Issue number7
DOIs
StatePublished - Jul 1 2009

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Cross-Sectional Studies
Nurses
Nursing
Critical Care Nursing
Nursing Care
Venous Thrombosis
Orthopedics
Blood Vessels
Intensive Care Units
Logistic Models
Regression Analysis
Outcome Assessment (Health Care)

Keywords

  • Intensity of nursing care
  • Nurse staffing
  • Patient outcomes

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Nurse staffing and patient outcomes in Belgian acute hospitals : Cross-sectional analysis of administrative data. / Van den Heede, Koen; Sermeus, Walter; Diya, Luwis; Clarke, Sean; Lesaffre, Emmanuel; Vleugels, Arthur; Aiken, Linda H.

In: International Journal of Nursing Studies, Vol. 46, No. 7, 01.07.2009, p. 928-939.

Research output: Contribution to journalArticle

Van den Heede, Koen ; Sermeus, Walter ; Diya, Luwis ; Clarke, Sean ; Lesaffre, Emmanuel ; Vleugels, Arthur ; Aiken, Linda H. / Nurse staffing and patient outcomes in Belgian acute hospitals : Cross-sectional analysis of administrative data. In: International Journal of Nursing Studies. 2009 ; Vol. 46, No. 7. pp. 928-939.
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