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The impact of hospital nursing organization on outcomes of hospitalized children

The impact of hospital nursing organization on outcomes of hospitalized children

Authors :
Tubbs Cooley, Heather Lynn
Tubbs Cooley, Heather Lynn
Source :
Dissertations available from ProQuest
Publication Year :
2010

Abstract

Growth of inpatient pediatric services has prompted questions about the quality of care delivered to children in the hospital setting. Prior research in adult populations has shown that the organization of hospital nurses varies across hospitals and significantly impacts patient outcomes. The purposes of this cross-sectional, observational study were threefold: to explore the relationship between hospital nursing organization and patient outcomes for children hospitalized with common conditions; to examine differences in outcomes between children's and general hospitals; and to explore the joint effects of hospital nursing organization and hospital type (children's versus general) on pediatric outcomes. Survey data from registered nurses collected in 2005 and 2006 by researchers at the University of Pennsylvania were merged with inpatient discharge summaries and hospital administrative data to form an analytic dataset for secondary analysis. Hospital nursing organization was empirically represented by measures of nurse staffing, nurse education, and the nurse practice environment at the hospital level. Prolonged length of stay, conditional length of stay, overall length of stay, and 21-day readmission were used as outcome measures. Logit and Cox regression models were utilized for the analysis, and robust standard errors were used to adjust for patient clustering. The most salient findings of the study relate to 21-day readmission; each one patient increase in a hospital's average patient-to-nurse staffing ratio was significantly associated with a 47.8% increase in the odds of 21-day readmission among children with surgical conditions. Similarly, each one standard deviation increase in a hospital's practice environment composite score was significantly associated with a 28.3% decrease in the odds of 21-day readmission in surgical patients. The results are timely given the recent emphasis within the Affordable Care Act of 2010 to reduce hospital readmission rates, an

Details

Database :
OAIster
Journal :
Dissertations available from ProQuest
Notes :
ENG
Publication Type :
Electronic Resource
Accession number :
edsoai.ocn857265305
Document Type :
Electronic Resource