The Impact of Nurse Staffing on In-Hospital Cardiac Arrest Patient Outcomes.

Nurse Staffing and Cardiac Arrest Outcomes;Nursing;Health Sciences;Nursing

Rochman, Monica FayeRedman, Richard W. ;

University of Michigan

关键词: Nurse Staffing and Cardiac Arrest Outcomes;    Nursing;    Health Sciences;    Nursing;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/96034/mrocwal_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

Delays in defibrillation for in-hospital cardiac arrest are associated with lower survival, with ten percent lower probability of survival for each additional minute of delay. Current guidelines dictate that patients should receive defibrillation within two minutes of recognition of a cardiac arrest. Certain hospital characteristics such as unmonitored units and cardiac arrests during nights and weekends have been associated with delays in defibrillation. These findings suggest that delayed defibrillation times may be related to the availability of nursing staff in the hospital at the time of arrest. This study examined the relationships between nurse staffing, defibrillation response times, and patient level outcomes of in-hospital cardiac arrests. A cross-sectional design was used. Independent variables were registered nurse hours per patient day and time-to-defibrillation. Dependent variables include both survival and neurological status at discharge. The measures used in this study are from the American Heart Association’s Get with the Guidelines national cardiac arrest database and from staffing productivity reports. Institutional review board exemption was obtained prior to secondary data analysis from a convenience sample of 299 patients in 22 units from one mid-western hospital. The findings indicate that there was a significant difference in mean staffing for delayed time to defibrillation, more than 2 minutes. While controlling for key covariates in the model, the analyses determined that one additional hour per patient day of RN care results in a 28% greater odds of surviving to discharge. The intensive care unit was found to be a predictor of time to defibrillation, survival, and neurological status at discharge. Finally, there was no relationship found between nurse staffing and neurological status at discharge. These important empirical finding both complement and differ from other studies.Nurse staffing measured at the time of the event was found to predict survival, which gives a more accurate synopsis of the work environment at the time of cardiac arrest. These findings are an important contribution to understanding nurses’ contribution to quality of care and improved patient outcomes.Future studies should include larger sample sizes and other measures of the work environment.