Skip Navigation U.S. Department of Health and Human Services www.hhs.gov
Agency for Healthcare Research Quality www.ahrq.gov
Archive print banner

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to www.ahrq.gov for current information.

Chapter 39. Nurse Staffing, Models of Care Delivery, and Interventions

(continued)

References

1. Brooks RH. Quality of health care. Part 2: measuring quality of care. N Engl J Med 1996;335:966-970.

2. Donabedian A. Evaluating the quality of medical care. Milbank Memorial Fund Quarterly 1966;44:166-203.

3. Donabedian A. Promoting quality through evaluating the process of patient care. Med Care 1968;6:181-202.

4. Donabedian A. Explorations in Quality Assessment and Monitoring. The definition of quality and approaches to its assessment. Ann Arbor, MI: Health Administration Press; 1980.

5. Donabedian A. The quality of care: How can it be assessed? JAMA 1988;260:1743-1748.

6. Wunderlich GS, Sloan FA, Davis CK. Nursing staff in hospitals and nursing homes: Is it adequate? Washington, D.C.: National Academy Press; 1996.

7. Cullum N. Identification and analysis of randomised controlled trials in nursing: a preliminary study. Qual Health Care 1997;6:2-6.

8. DeGroot HA. Patient Classification System Evaluation: Part 1: Essential System Elements. J of Nurs Admin 1989;19:30-35.

9. Finnigan S. When patient classification systems fail. Aspens Advis Nurse Exec 1993;8:1-3.

10. Finnigan SA, Abel M, Dobler T, Hudon L, Terry B. Automated patient acuity. Linking nursing systems and quality measurement with patient outcomes. J Nurs Adm 1993;23:62-71.

11. Lawson KO, Formella NM, Smeltzer CH, Walters RM. Redefining the purpose of patient classification [published erratum appears in Nurs Econ 1993 Nov-Dec;11(6):382]. Nurs Econ 1993;11:298-302.

12. Cohen MM, O'Brien-Pallas LL, Copplestone C, Wall R, Porter J, Rose DK. Nursing workload associated with adverse events in the postanesthesia care unit. Anesthesiology 1999;91:1882-1890.

13. Garfield M, Jeffrey R, Ridley S. An assessment of the staffing level required for a high-dependency unit. Anaesthesia 2000;55:137-143.

14. Moreno R, Reis Miranda D. Nursing staff in intensive care in Europe: the mismatch between planning and practice. Chest 1998;113:752-758.

15. DeGroot HA. Patient classification systems and staffing. Part 2, Practice and process. J Nurs Adm 1994;24:17-23.

16. DeGroot HA. Patient Classification System Evaluation: Part 2, System Selection and Implementation. J of Nurs Admin 1989;19:24-30.

17. DeGroot HA. Patient classification systems and staffing. Part 1, Problems and promise. J Nurs Adm 1994;24:43-51.

18. Davidhizar R, Mallow GE, Bechtel GA, Giger JN. A patient classification system for the chronic psychiatric patient. Aust N Z J Ment Health Nurs 1998;7:126-133.

19. Detwiler C, Clark MJ. Acuity classification in the urgent care setting. J Nurs Adm 1995;25:53-61.

20. Dunbar LJ, Diehl BC. Developing a patient classification system for the pediatric rehabilitation setting. Rehabil Nurs 1995;20:328-332.

21. Freund L, Burrows-Hudson S, Preisig P. Development of a patient classification system for chronic hemodialysis patients. Am J Kidney Dis 1998;31:818-829.

22. Giovannetti P, Johnson JM. A new generation of patient classification system. JONA 1990;20:33-40.

23. Godin M. A patient classification system for the hemodialysis setting. Nurs Manage 1995;26:66-67.

24. Lovett RB, Reardon MB, Gordon BK, McMillan S. Validity and reliability of medical and surgical oncology patient acuity tools. Oncol Nurs Forum 1994;21:1709-1717.

25. Lovett RB, Wagner L, McMillan S. Validity and reliability of a pediatric hematology oncology patient acuity tool. J Pediatr Oncol Nurs 1991;8:122-130.

26. O'Brien-Pallas L, Irvine D, Peereboom E, Murray M. Measuring nursing workload: understanding the variability. Nursing Economics 1997;15:171-182.

27. O'Brien-Pallas LL, Cockerill RW. Satisfaction with nursing workload systems: report of a survey of Canadian hospitals. Part B. Can J Nurs Adm 1990;3:23-26.

28. Walts LM, Kapadia AS. Patient classification system: an optimization approach. Health Care Manage Rev 1996;21:75-82.

29. Aiken LH, Smith HL, Lake ET. Lower Medicare mortality among a set of hospitals known for good nursing care. Med Care 1994;32:771-787.

30. Shortell SM, Zimmerman JE, Rousseau DM, et al. The performance of intensive care units: does good management make a difference? Medical Care 1994;32:508-525.

31. Dodd MJ, Dibble SL, Miaskowski C, et al. Randomized clinical trial of the effectiveness of 3 commonly used mouthwashes to treat chemotherapy-induced mucositis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 2000;90:39-47.

32. Robertson R, Samuelson C. Should nurse patient ratios be legislated?—Pros and cons. Georgia Nursing 1996;56:2.

33. Shoemake A. Solutions to the home healthcare nursing shortage. Home Healthc Nurse 1994;12:35-39.

34. Davis MA, Freeman JW. Excess demand and cost relationships among Kentucky nursing homes. Health Care Financ Rev 1994;15:137-152.

35. Carr EC. Talking on the telephone with people who have experienced pain in hospital: clinical audit or research? J Adv Nurs 1999;29:194-200.

36. Waterman H, Waterman C. Trends in ophthalmology services, nursing skill-mix and education: 2nd national survey. J Adv Nurs 1999;30:942-949.

37. Miskella C, Avis M. Care of the dying person in the nursing home: exploring the care assistants' contribution including commentary by Froggatt K and Sale DNT. European Journal of Oncology Nursing 1998;2:80-88.

38. Eliopoulos C. Nurse staffing in long-term care facilities: the case against a high ratio of RNs. J Nurs Adm 1983;13:29-31.

39. Gagnon AJ, Edgar L, Kramer MS, Papageorgiou A, Waghorn K, Klein MC. A randomized trial of a program of early postpartum discharge with nurse visitation. Am J Obstet Gynecol 1997;176:205-211.

40. Cumbey DA, Alexander JW. The relationship of job satisfaction with organizational variables in public health nursing. J Nurs Adm 1998;28:39-46.

41. Schmidt CE, Gillies DA, Biordi D, Child DA. Marketing the home healthcare agency. Do nurses and physicians agree? J Nurs Adm 1990;20:9-17.

42. Jansen PGM, Kerkstra A, Abu Saad HH, van der Zee J. Models of differentiated practice and specialization in community nursing: a review of the literature. J Adv Nurs 1996;24:968-980.

43. Carey RG, Teeters JL. CQI case study: reducing medication errors. Jt Comm J Qual Improv 1995;21:232-237.

44. Dinc L, Erdil F. The effectiveness of an educational intervention in changing nursing practice and preventing catheter-related infection for patients receiving total parenteral nutrition. Int J Nurs Stud 2000;37:371-379.

45. Cohran J, Larson E, Roach H, Blane C, Pierce P. Effect of intravascular surveillance and education program on rates of nosocomial bloodstream infections. Heart Lung 1996;25:161-164.

46. Flynn ER, Wolf ZR, McGoldrick TB, Jablonski RA, Dean LM, McKee EP. Effect of three teaching methods on a nursing staff's knowledge of medication error risk reduction strategies. J Nurs Staff Dev 1996;12:19-26.

47. Lundgren A, Wahren LK. Effect of education on evidence-based care and handling of peripheral intravenous lines. J Clin Nurs 1999;8:577-585.

48. Gould D, Chamberlain A. The use of a ward-based educational teaching package to enhance nurses' compliance with infection control procedures. J Clin Nurs 1997;6:55-67.

49. Hendryx MS, Fieselmann JF, Bock MJ, Wakefield DS, Helms CM, Bentler SE. Outreach education to improve quality of rural ICU care. Results of a randomized trial. Am J Respir Crit Care Med 1998;158:418-23.

50. Kite K. Changing mouth care practice in intensive care: implications of the clinical setting context. Intensive Crit Care Nurs 1995;11:203-209.

51. Knoblauch SC, Wilson CJ. Clinical outcomes of educating nurses about pediatric pain management. Outcomes Manag Nurs Pract 1999;3:87-89.

52. Spetz J, Coffman J. Maintaining an adequate supply of registered nurses in California: the case for increased public investment in nursing education [abstract]. Abstract Book/Association for Health Services Research 1999:426-427.

53. Barnason S, Merboth M, Pozehl B, Tietjen MJ. Utilizing an outcomes approach to improve pain management by nurses: a pilot study. Clin Nurse Spec 1998;12:28-36.

54. Fernandez-Perez C, Tejada J, Carrasco M. Multivariate time series analysis in nosocomial infection surveillance: a case study. Int J Epidemiol 1998;27:282-288.

55. Goetz AM, Kedzuf S, Wagener M, Muder RR. Feedback to nursing staff as an intervention to reduce catheter-associated urinary tract infections. Am J Infect Control 1999;27:402-404.

56. Huda A, Wise LC. Evolution of compliance within a fall prevention program. J Nurs Care Qual 1998;12:55-63.

57. Moore SM, Wise L. Reducing nosocomial pressure ulcers. J Nurs Adm 1997;27:28-34.

58. Frykberg RG. The team approach in diabetic foot management. Adv Wound Care 1998;11:71-77.

59. Gunningberg L, Lindholm C, Carlsson M, Sjoden PO. Implementation of risk assessment and classification of pressure ulcers as quality indicators for patients with hip fractures. J Clin Nurs 1999;8:396-406.

60. Rubenstein LZ, Robbins AS, Josephson KR, Schulman BL, Osterweil D. The value of assessing falls in an elderly population. A randomized clinical trial. Ann Intern Med 1990;113:308-316.

61. Meier PA, Fredrickson M, Catney M, Nettleman MD. Impact of a dedicated intravenous therapy team on nosocomial bloodstream infection rates. Am J Infect Control 1998;26:388-392.

62. Naylor M, Brooten D, Jones R, Lavizzo-Mourey R, Mezey M, Pauly M. Comprehensive discharge planning for the hospitalized elderly. A randomized clinical trial. Ann Intern Med 1994;120:999-1006.

63. Pratt R, Burr G, Leelarthaepin B, Blizard P, Walsh S. The effects of All-RN and RN-EN staffing on the quality and cost of patient care. Aust J Adv Nurs 1993;10:27-39.

64. Ridsdale L, Kwan I, Cryer C. Newly diagnosed epilepsy: can nurse specialists help? A randomized controlled trial. Epilepsy Care Evaluation Group. Epilepsia 2000;41:1014-1019.

65. York R, Brown LP, Samuels P, et al. A randomized trial of early discharge and nurse specialist transitional follow-up care of high-risk childbearing women. Nursing Research 1997;46:254-261.

66. Evans ML, Dick MJ, Shields DR, Shook DM, Smith MB. Postpartum sleep in the hospital. Relationship to taking-in and taking-hold. Clin Nurs Res 1998;7:379-389.

67. Mock V, Dow KH, Meares CJ, et al. Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncol Nurs Forum 1997;24:991-1000.

68. Sheely LC. Sleep disturbances in hospitalized patients with cancer. Oncol Nurs Forum 1996;23:109-111.

69. ter Riet G, Kessels AG, Knipschild PG. Randomized clinical trial of ascorbic acid in the treatment of pressure ulcers. J Clin Epidemiol 1995;48:1453-1460.

70. Hardyck C, Petrinovich L. Reducing urinary tract infections in catheterized patients. Ostomy/Wound Management 1998;44:36-8, 40, 42-43.

71. Stotts NA, Barbour S, Griggs K, et al. Sterile versus clean technique in postoperative wound care of patients with open surgical wounds: a pilot study. J Wound Ostomy Continence Nurs 1997;24:10-18.

72. Wipke-Tevis DD, Stotts NA. Effect of dressings on saphenous vein harvest incision pain, distress and cosmetic result. Prog Cardiovasc Nurs 1998;13:3-13.

73. Gilcreast DM, Stotts NA, Froelicher ES, Baker LL, Moss KM. Effect of electrical stimulation on foot skin perfusion in persons with or at risk for diabetic foot ulcers. Wound Repair Regen 1998;6:434-441.

74. Spetz J, Seago JA, Coffman J, Rosenoff E, O'Neil E. Minimum Nurse Staffing Ratios in California Acute Care Hospitals. San Francisco, CA: University of California, San Francisco Center for the Health Professions; 2000.

75. Rogut L, Hudson A. Meeting patients' needs: quality care in a changing environment. Pap Ser United Hosp Fund N Y 1995:1-33.

76. Minion M, Ogden C, Brune D. Patient and staff needs drive changes on a postsurgical unit. Nurs Adm Q 1994;18:18-28.

77. Managed care and nursing: a view from the front lines. Massachusetts Nurse 1995;65:4, 10-11.

78. Seago JA, Faucett J. Job strain among registered nurses and other hospital workers. J Nurs Adm 1997;27:19-25.

79. Seago JA. Evaluation of work redesign: Patient focused care. J Nurs Adm 1999;29:31-38.

80. Sochalski J, Aiken LH, Fagin C. Hospital Restructuring in the United States, Canada, and Western Europe: An Outcomes Research Agenda. Med Care 1997;35:OS13-25.

81. Sochalski J, Boulis A, Shamian J, Buchan J, Muller-Mundt G. Lessons for restructuring the nursing workforce in North American and European hospitals [abstract]. Abstract Book / Association for Health Services Research 1997;14:207-208.

82. Weinberg DB. Why are the nurses crying? Restructuring, power, and control in an American hospital. Boston, MA: Harvard; 2000.

83. Blegen MA, Goode CJ, Reed L. Nurse staffing and patient outcomes. Nurs Res 1998;47:43-50.

84. Blegen MA, Vaughn T. A multisite study of nurse staffing and patient occurrences. Nursing Economics 1998;16:196-203.

85. McCloskey JM. Nurse staffing and patient outcomes. Nursing Outlook 1998;46:199-200.

86. Reed L, Blegen MA, Goode CS. Adverse patient occurrences as a measure of nursing care quality. J Nurs Adm 1998;28:62-69.

87. Stevenson B, Mills EM, Welin L, Beal KG. Falls risk factors in an acute-care setting: a retrospective study. Can J Nurs Res 1998;30:97-111.

88. Sutton JC, Standen PJ, Wallace WA. Patient accidents in hospital: incidence, documentation and significance. Br J Clin Pract 1994;48:63-66.

89. Tutuarima JA, de Haan RJ, Limburg M. Number of nursing staff and falls: a case-control study on falls by stroke patients in acute-care settings. J Adv Nurs 1993;18:1101-1105.

90. Wolf ZR, McGoldrick TB, Flynn ER, Warwick F. Factors associated with a perceived harmful outcome from medication errors: a pilot study. J Contin Educ Nurs 1996;27:65-74.

91. Medicare. Available at: www.state.ia.us/ins/shiip/resources.html. Accessed June 23, 2001.

92. Rhode Island Department of Health. Available at: http://www.health.state.ri.us/. Accessed June, 23 2001.

93. California Consumer Health Scope. Available at: www.healthscope.org/hospital/where.asp. Accessed June 30, 2001.

94. Denby C, Hogan N. Retaining Nursing Talent. In: Company TAB, ed. The Journey Begins. Atlanta, GA; 1999.

95. Ballard K. Legislating Patient Advocacy: Nurse Staffing Ratios. In: Curtin L, ed. A Staffing Crisis: Nurse/Patient Ratios. Washington, DC; 2000.

96. Ober S. Legislating Patient Advocacy: Nurse Staffing Ratios. In: Curtin L, ed. Staffing Crisis: Nurse/Patient Ratios Washington, DC; 2000.

97. 1997 NJSNA annual survey. New Jersey Nurse 1997;27:7.

98. Staffing is the top priority for MNA bargaining units. Massachusetts Nurse 1999;69:5.

99. MNA members take to the streets for safe patient care. Massachusetts Nurse 1999;69:12.

100. Staffing is the top priority for MNA bargaining units. Massachusetts Nurse 1999;69:5.

101. New study confirms critical role of low nurse-to-patient ratio. Massachusetts Nurse 1999;69:5.

102. Maryland RNs win big in a pact that sets patient-load limits. Am J Nurs 1990;127:134.

103. Cape Cod Hospital RNs ratify landmark agreement. Massachusetts Nurse 1997;67:1-2.

104. Ratio ruckus. Modern Healthcare 1998;28:48.

105. Alexander JW, Bauerschmidt AD. Implications for nursing administration of the relationship of technology and structure to quality of care. Nurs Adm Q 1987;11:1-10.

106. Currell R, Wainwright P, Urquhart C. Nursing record systems: effects on nursing practice and health care outcomes (Cochrane Review). In: The Cochrane Library, Issue 4, 2000. Oxford.

107. Curtin LL. Nursing productivity: from data to definition. Nurs Manag 1995;26:25, 28-29, 32-36.

108. Kovner C, Rosenfeld P. Practice and employment trends among nurse practitioners in New York State. J N Y State Nurses Assoc 1997;28:4-8.

109. Park HA, Park JH. Development of a computerized patient classification and staffing system. Stud Health Technol Inform 1997;46:508-511.

110. Spetz J. The measurement of technology in studies of the hospital industry [abstract]. Ahsr and Fhsr Annual Meeting Abstract Book 1996;13:100.

111. Mitchell PH, Shortell SM. Adverse outcomes and variations in organization of care delivery. Med Care 1997;35:NS19-32.

112. Brooten D, Roncoli M, Finkler S, Arnold L, Cohen A, Mennuti M. A randomized trial of early hospital discharge and home follow-up of women having cesarean birth. Obstet Gynecol 1994;84:832-838.

113. Alexander JS, Younger RE, Cohen RM, Crawford LV. Effectiveness of a nurse-managed program for children with chronic asthma. J Pediatr Nurs 1988;3:312-317.

114. Jorgensen HS, Kammersgaard LP, Houth J, et al. Who benefits from treatment and rehabilitation in a stroke Unit? A community-based study. Stroke 2000;31:434-439.

115. Aiken LH, Sloane DM, Lake ET, Sochalski J, Weber AL. Organization and outcomes of inpatient AIDS care. Med Care 1999;37:760-772.

116. Hartz AJ, Krakauer H, Kuhn EM, et al. Hospital characteristics and mortality rates. N Engl J Med; 1989:1720-1725.

117. Hunt J, Hagen S. Occasional paper. Nurse to patient ratios and patient outcomes. Nursing Times 1998;94:63-66.

118. Robertson RH, Hassan M. Staffing intensity, skill mix and mortality outcomes: the case of chronic obstructive lung disease. Health Services Management Research 1999;12:258-268.

119. Hagen S, Hunt J. Investigating the relationship between nurse: patient ratios and patient outcomes using nationally collected data [abstract]. Abstract Book/Association for Health Services Research 1998;15:103.

120. Hunt J, Hagen S. Nurse to patient ratios and patient outcomes. Nurs Times 1998;94:63-66.

121. Needleman J, Buerhaus PI, Mattke S, Stewart M, Zelevinsky K. Nurse Staffing and Patient Outcomes in Hospitals. Boston, MA: US Department of Health and Human Services, Health Resources and Service Administration; 2001.

122. American Nurses Association Network Inc. Implementing nursing's report card: A study of RN staffing, length of stay, and patient outcomes. Washington, DC: American Nurses Publishing; 1997:32.

123. American Nurses Association Network Inc. Nurse Staffing and Patient Outcomes in the Inpatient Hospital Setting. Washington, DC: American Nurses Publishing; 2000:53.

124. Kovner C, Gergen PJ. Nurse staffing levels and adverse events following surgery in U.S. hospitals. Image J Nurs Sch 1998;30:315-321.

125. Lichtig LK, Knauf RA, Milholland DK. Some impacts of nursing on acute care hospital outcomes. J Nurs Adm 1999;29:25-33.

126. Fridkin SK, Pear SM, Williamson TH, Galgiani JN, Jarvis WR. The role of understaffing in central venous catheter-associated bloodstream infections. Infect Control Hosp Epidemiol 1996;17:150-158.

127. Flood SD, Diers D. Nurse staffing, patient outcome and cost. Nurs Manag 1988;19:34-35, 38-39, 42-43.

128. Kuhn EM, Hartz AJ, Gottlieb MS, Rimm AA. The relationship of hospital characteristics and the results of peer review in six large states. Med Care 1991;29:1028-1038.

129. Wan TT, Shukla RK. Contextual and organizational correlates of the quality of hospital nursing care. QRB Qual Rev Bull 1987;13:61-64.

130. Grillo-Peck AM, Risner PB. The Effect of a Partnership Model on Quality and Length of Stay. Nursing Economics 1995;13:367-374.

131. Pierce SF. Nurse-sensitive health care outcomes in acute care settings: an integrative analysis of the literature. Journal of Nursing Care Quality 1997:60-72.

132. Czaplinski C, Diers D. The effect of staff nursing on length of stay and mortality. Med Care 1998;36:1626-1638.

133. Aiken LH, Sloane DM. Effects of specialization and client differentiation on the status of nurses: the case of AIDS. J Health Soc Behav 1997;38:203-222.

134. Aubert RE, Herman WH, Waters J, et al. Nurse case management to improve glycemic control in diabetic patients in a health maintenance organization. A randomized, controlled trial. Ann Intern Med 1998;129:605-612.

135. Borkowski V. Implementation of a managed care model in an acute care setting. J Healthc Qual 1994;16:25-27, 30.

136. Clark JM, Maben J. Health promotion in primary health care nursing: the development of quality indicators. Health Educ J 1999;58:99-119.

137. Dring R, Hiott B, Elliott K. Case management: a case study. J Neurosci Nurs 1994;26:166-169.

138. Jones J, Rowan K. Is there a relationship between the volume of work carried out in intensive care and its outcome? Int J Technol Assess Health Care 1995;11:762-769.

139. Strzalka A, Havens DS. Nursing care quality: comparison of unit-hired, hospital float pool, and agency nurses. J Nurs Care Qual 1996;10:59-65.

140. Westcott E, Dunn V. An exploration of the value of specialist neurosurgical nurses... including commentary by Northcott N. NT Research 1998;3:421-431.

141. Gilbert M, Counsell C. Planned change to implement a restraint reduction program J Nurs Care Qual 1999;13:57-64. Published erratum appears in J Nurs Care Qual 1999;13.

142. von Koch L, Widen Holmqvist L, Kostulas V, Almazan J, de Pedro-Cuesta J. A randomized controlled trial of rehabilitation at home after stroke in Southwest Stockholm: outcome at six months. Scand J Rehabil Med 2000;32:80-86.

143. Wagner EH, LaCroix AZ, Grothaus L, et al. Preventing disability and falls in older adults: a population-based randomized trial. Am J Public Health 1994;84:1800-1806.

144. Day G, Hindmarsh J, Hojna C, Roy G, Ventimiglia N. Improving medication administration through an enhanced occurrence reporting system. J Nurs Care Qual 1994;9:51-56.

145. Mendelson MH, Short LJ, Schechter CB, et al. Study of a needleless intermittent intravenous-access system for peripheral infusions: analysis of staff, patient, and institutional outcomes. Infect Control Hosp Epidemiol 1998;19:401-406.

146. Rush J, Fiorino-Chiovitti R, Kaufman K, Mitchell A. A randomized controlled trial of a nursery ritual: wearing cover gowns to care for healthy newborns. Birth 1990;17:25-30.

147. Gilbert B. Facts, not myths. Study shows for-profit hospital conversions help communities by injecting capital. Mod Healthc 1997:54.

148. Moore MM, Nguyen D, Nolan SP, et al. Interventions to reduce decibel levels on patient care units. Am Surg 1998;64:894-899.

149. Spetz J. Hospital use of nursing personnel: holding steady through the 1990s. J Nurs Adm 2000;30:344-346.

150. Coffman J, Spetz J. Maintaining an adequate supply of RNs in California. Image J Nurs Sch 1999;31:389-393.

151. Coffman J, Spetz J, Seago JA, Rosenoff E, O;Neil E. Nursing in California: A Workforce in Crisis. San Francisco, CA: UCSF Center for the Health Professions; 2001:91.

152. Aiken LH, Smith HL, Lake ET. Lower medicare mortality among a set of hospitals known for good nursing care. Med Care 1994;32:771-787.

153. Aiken LH, Clarke SP, Sloane DM. Hospital Restructuring: Does it Adversely Affect Care and Outcomes? J Health Hum Serv Adm 2000; In press.

154. Archibald LK, Manning ML, Bell LM, Banerjee S, Jarvis WR. Patient density, nurse-to-patient ratio and nosocomial infection risk in a pediatric cardiac intensive care unit. Pediatr Infect Dis J 1997;16:1045-1048.

155. Harbarth S, Sudre P, Dharan S, Cadenas M, Pittet D. Outbreak of Enterobacter cloacae related to understaffing, overcrowding, and poor hygiene practices. Infect Control Hosp Epidemiol 1999;20:598-603.

156. Robert J, Fridkin SK, Blumberg HM, et al. The influence of the composition of the nursing staff on primary bloodstream infection rates in a surgical intensive care unit. Infect Control Hosp Epidemiol 2000;21:12-17.

157. Taunton RL, Kleinbeck SV, Stafford R, Woods CQ, Bott MJ. Patient outcomes. Are they linked to registered nurse absenteeism, separation, or work load? J Nurs Adm 1994;24:48-55.

158. Amaravadi RK, Dimick JB, Pronovost PJ, Lipsett PA. ICU nurse-to-patient ratio is associated with complications and resource use after esophagectomy. Intensive Care Med 2000;26:1857-1862.

159. Silber JH, Rosenbaum PR, Ross RN. Comparing the contributions of groups of predictors: which outcomes vary with hospital rather than patient characteristics? Journalof the American Statistical Association 1995;90:7-18.

160. Zimmerman JE, Shortell SM, Knaus WA, et al. Value and cost of teaching hospitals: a prospective, multicenter, inception cohort study . Crit Care Med 1993;21:1432-1442.

161. Wan TT. Hospital variations in adverse patient outcomes. Qual Assur Util Rev 1992;7:50-53.

162. Shukla R. Structure vs. people in primary nursing: An inquiry. Nursing Research 1981;30:236-241.


Return to Contents
Proceed to Next Chapter

 

The information on this page is archived and provided for reference purposes only.

 

AHRQ Advancing Excellence in Health Care