Nurse staffing is an important strategy to prevent medication error in community hospitals.

The prevalence of medication administration errors continues to be a problem requiring the attention of nurse leaders. In this study the relationship between nurse staffing and the occurrence of medication errors was examined. Using a retrospective design, researchers analyzed secondary data from administrative databases of one hospital containing 801 weekly staffing intervals and 31,080 patient observations. The current study shows that increasing the number of RN hours and decreasing or eliminating LPN hours can be a strategy to reduce medication errors.

Evidence-based design for a safer environment without construction.

This article explores the implementation of evidence-based design elements in the renovation of 1 patient room on a budget of $3500. The functional mock-up was evaluated through survey and focus groups by staff, visitors, and physicians to identify problematic features. Overall, participants perceived that design elements were effective with only minor modification needed before replication. Suggestions are provided for ways to implement evidence-based design with limited funds.

A case for measuring governance.

Shared governance is promoted as a management innovation designed to improve outcomes of quality patient care, nurse job satisfaction, productivity, and nurse retention. Reported studies have not measured the degree of governance. The Index of Profession Nurse Governance is a valid, reliable tool that can be used to measure the degree of governance, to assess the status and progress of implementation of governance, and in studies relating shared governance to outcomes. An example of the use of the Index of Profession Nurse Governance in one hospital to assess the degree of shared governance over time is described.

Linking economics and quality: developing an evidence-based nurse staffing tool.

The evidence linking nurse staffing with patient outcomes has been established; however, incorporating the evidence into practice is lagging. This article describes a practice/academic collaborative initiated to promote the translation of staffing research into decision-making through the development of an evidence-based staffing tool. Reports of previous research on nurse staffing and patient and financial outcomes are summarized, and aspects of the 2 phases of the collaborative to date are discussed. In the initial phase, a pilot research study on nurse staffing and patient outcomes in medical-surgical units support previous findings that higher nurse staffing results in positive patient outcomes. The focus in the current phase is expansion of the pilot research and the development of a decision-making staffing tool based on the additional staffing research. Identifying the critical data elements and sources of the data are major challenges to achieving the project objectives. Other challenges are maintaining interest and creating wide-spread understanding of the importance of nurse managers having access to timely, useable information. The success of the collaborative is due to the commitment and participation of leaders from various disciplines in both organizations.

Effects of nurse staffing on hospital-acquired conditions and length of stay in community hospitals.

BACKGROUND: Error-free care is the goal of health care professionals, consumers, and public policy makers. Because nurses can be the last barrier between a patient and an error, there is a need to examine this pressing nursing issue-nurse staffing. PURPOSE: This research examined the predictive relationships between nurse staffing and patient outcomes in hospitals. METHOD: A quantitative, cross-sectional design was used to examine data on nearly 35,000 patients from 11 medical-surgical units in 4 hospitals. Data were extracted from administrative databases over a 2-year period and were analyzed using hierarchical linear modeling. DISCUSSION: Findings from the study indicated that higher registered nurse (RN) and licensed practical nurse hours per equivalent patient day and higher percentages of RNs in the skill mix predicted a lower number of adverse events and shorter lengths of stay, controlling for patient age and complications. CONCLUSION: This study, with its improved methodology, supports previous findings and should be used as evidence for changes to nurse staffing.