HOURS OF NURSING CARE: RELATIONSHIP TO PATIENT OUTCOMES.
Contributors: University of North Carolina at Chapel Hill.
Published: 1995
Number of pages: 169
Subjects: Health Sciences, Nursing.; Health Sciences, Health Care Management.
Description: The objective of this research was to investigate the degree to which the available hours of Registered Nurse care provided to patients in acute, short-term hospitals contributed to their outcomes.

Using Donabedian's systems theory for assessing quality in health care, and Henderson's needs theory of nursing practice as the theoretical framework, this study was a retrospective analysis of archival data from short-term community hospitals in North Carolina investigating the relationship between the available hours of RN care and patient outcomes, defined as discharge disposition (discharged home to self-care, home with care provided by a home-health agency, or to a skilled or intermediate nursing facility) and death. "Typical day" nurse staffing data was obtained from the archives of the NC Board of Nursing for 100 hospitals visited by them during the years 1988-1993. Administrative data on 146,000 patient discharges, covering a three month period coinciding with the dates of the BON site visit was obtained from the North Carolina Medical Database Commission. Hospital contextual data, including size, occupancy rate, ownership, teaching status, technology index and physician specialty, were gathered from five sources and included in the analysis as control variables.

Descriptive analysis on patient, nursing hours and hospital characteristics fully described these data. Multiple logistic regression analysis was used to test 16 hypotheses. Statistical significance was found for all but three of the relationships between total hours of RN care and patient discharge disposition, but in the opposite direction of the hypotheses. These results suggest that dying, nursing home placement and home care patients receive more nursing care prior to discharge or death. Nursing hours were associated with major diagnostic categories and confounded by stays in intensive care units. Clinical relevance was not supported, in that all odds ratios were under a prespecified level of 2.

Implications included the questioning of some of the assumptions underlying the research, the proposal for more in-depth analysis of the unique dataset constructed for the analysis, and policy implications.
Notes: Source: Dissertation Abstracts International, Volume: 57-02, Section: B, page: 0992.

Thesis (PH.D.)--THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL, 1995.

School code: 0153.