NURSING INTENSITY: RELATIONSHIP BETWEEN PREDICTED AND ACTUAL NURSING RESOURCE CONSUMPTION AND THE EFFECT ON PATIENT OUTCOMES.
Contributors: University of California, San Francisco.
Published: 1991
Number of pages: 197
Subjects: Health Sciences, Nursing.
Description: The purpose of this research was to determine the effect of providing predicted hours of nursing care on the outcomes of cost of nursing care and length of stay (LOS). A nursing intensity of patient care model was developed to provide the conceptual framework.

Data for this correlational study were collected at three acute care facilities in Northern California during October, 1989 for Phase I and from December, 1989 to July, 1990 for Phase II. During Phase I, predicted and actual hours provided to a sample of 120 patients were obtained on one medical and on surgical unit at each of the sites. Audits of the medical records provided the predicted and actual hours for each patient for each shift on four study days. Regression analysis found predicted hours explained 83.8% of the actual hours provided to individual patients. Predicted and actual unit hours for the six study units were highly correlated and ranged from (r =.795 to r =.995). Responses to a Perceptions of Staffing Adequacy Questionnaire were congruent with the individual and unit level of staffing.

During Phase II, data were collected on a total sample of 240 patients admitted to one of three study units with a diagnoses of one of the four selected Diagnosis Related Groups (DRGs). Records were audited until a sample of 20 patients in each DRG at each site was attained. Results of multiple regression of predicted and actual hours to LOS and cost of care were significant with respective $R\sp2 s$ of.927 and.930. However, significant differences were also found between the predicted and actual hours of care. Analysis of this variance between predicted and actual hours indicated patients who received the predicted hours of care had shorter lengths of stay and lower costs of nursing care. These relationships were dependent upon the hospital to which the patient was admitted, and the DRG assigned. Complex relationships were found between the hours of care, staff mix, LOS, and cost of care.

Standard costing techniques were defined and applied consistently across sites to determine cost ratios and the cost of care. Direct nursing costs accounted for 20% of DRG reimbursements and 25% of total hospital costs for this sample.
Notes: Source: Dissertation Abstracts International, Volume: 52-08, Section: B, page: 4129.

Thesis (D.N.S.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1991.

School code: 0034.