Staffing levels and nursing‐sensitive patient outcomes: Umbrella review and qualitative study
Objective To derive a comprehensive list of nursing‐sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert opinion. Data Sources/Study Setting Published literature reviews and their primary studies analyzing the link between nurse staffing levels and NSPO...
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| Published in | Health services research Vol. 56; no. 5; pp. 885 - 907 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Health Research and Educational Trust
01.10.2021
Blackwell Publishing Ltd John Wiley and Sons Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0017-9124 1475-6773 1475-6773 |
| DOI | 10.1111/1475-6773.13647 |
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| Abstract | Objective
To derive a comprehensive list of nursing‐sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert opinion.
Data Sources/Study Setting
Published literature reviews and their primary studies analyzing the link between nurse staffing levels and NSPOs and interviews with 16 experts on nursing care.
Study Design
Umbrella review and expert interviews.
Data Collection/Extraction Methods
We screened three electronic databases for literature reviews on the association between nurse staffing levels and NSPOs. After screening 430 potentially relevant records, we included 15 literature reviews, derived a list of 22 unique NSPOs from them, and ranked these in a systematic fashion according to the strength of evidence existing for their association with nurse staffing. We extended this list of NSPOs based on data from expert interviews.
Principal Findings
Of the 22 NSPOs discussed in the 15 included literature reviews, we rated the strength of evidence for four as high, for five as moderate, and for 13 outcomes as low. Four additional NSPOs that have not been considered in literature were identified through expert interviews.
Conclusions
We identified strong evidence for a significant association between nurse staffing levels and NSPOs. Our results may guide researchers in selecting NSPOs they might wish to prioritize in future studies. In particular, rarely studied NSPOs as well as NSPOs that were only identified through expert interviews but have not been considered in literature so far should be subject to further research. |
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| AbstractList | ObjectiveTo derive a comprehensive list of nursing‐sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert opinion.Data Sources/Study SettingPublished literature reviews and their primary studies analyzing the link between nurse staffing levels and NSPOs and interviews with 16 experts on nursing care.Study DesignUmbrella review and expert interviews.Data Collection/Extraction MethodsWe screened three electronic databases for literature reviews on the association between nurse staffing levels and NSPOs. After screening 430 potentially relevant records, we included 15 literature reviews, derived a list of 22 unique NSPOs from them, and ranked these in a systematic fashion according to the strength of evidence existing for their association with nurse staffing. We extended this list of NSPOs based on data from expert interviews.Principal FindingsOf the 22 NSPOs discussed in the 15 included literature reviews, we rated the strength of evidence for four as high, for five as moderate, and for 13 outcomes as low. Four additional NSPOs that have not been considered in literature were identified through expert interviews.ConclusionsWe identified strong evidence for a significant association between nurse staffing levels and NSPOs. Our results may guide researchers in selecting NSPOs they might wish to prioritize in future studies. In particular, rarely studied NSPOs as well as NSPOs that were only identified through expert interviews but have not been considered in literature so far should be subject to further research. To derive a comprehensive list of nursing-sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert opinion.OBJECTIVETo derive a comprehensive list of nursing-sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert opinion.Published literature reviews and their primary studies analyzing the link between nurse staffing levels and NSPOs and interviews with 16 experts on nursing care.DATA SOURCES/STUDY SETTINGPublished literature reviews and their primary studies analyzing the link between nurse staffing levels and NSPOs and interviews with 16 experts on nursing care.Umbrella review and expert interviews.STUDY DESIGNUmbrella review and expert interviews.We screened three electronic databases for literature reviews on the association between nurse staffing levels and NSPOs. After screening 430 potentially relevant records, we included 15 literature reviews, derived a list of 22 unique NSPOs from them, and ranked these in a systematic fashion according to the strength of evidence existing for their association with nurse staffing. We extended this list of NSPOs based on data from expert interviews.DATA COLLECTION/EXTRACTION METHODSWe screened three electronic databases for literature reviews on the association between nurse staffing levels and NSPOs. After screening 430 potentially relevant records, we included 15 literature reviews, derived a list of 22 unique NSPOs from them, and ranked these in a systematic fashion according to the strength of evidence existing for their association with nurse staffing. We extended this list of NSPOs based on data from expert interviews.Of the 22 NSPOs discussed in the 15 included literature reviews, we rated the strength of evidence for four as high, for five as moderate, and for 13 outcomes as low. Four additional NSPOs that have not been considered in literature were identified through expert interviews.PRINCIPAL FINDINGSOf the 22 NSPOs discussed in the 15 included literature reviews, we rated the strength of evidence for four as high, for five as moderate, and for 13 outcomes as low. Four additional NSPOs that have not been considered in literature were identified through expert interviews.We identified strong evidence for a significant association between nurse staffing levels and NSPOs. Our results may guide researchers in selecting NSPOs they might wish to prioritize in future studies. In particular, rarely studied NSPOs as well as NSPOs that were only identified through expert interviews but have not been considered in literature so far should be subject to further research.CONCLUSIONSWe identified strong evidence for a significant association between nurse staffing levels and NSPOs. Our results may guide researchers in selecting NSPOs they might wish to prioritize in future studies. In particular, rarely studied NSPOs as well as NSPOs that were only identified through expert interviews but have not been considered in literature so far should be subject to further research. Data Collection/Extraction Methods: We screened three electronic databases for literature reviews on the association between nurse staffing levels and NSPOs. After screening 430 potentially relevant records, we included 15 literature reviews, derived a list of 22 unique NSPOs from them, and ranked these in a systematic fashion according to the strength of evidence existing for their association with nurse staffing. We extended this list of NSPOs based on data from expert interviews. * We conducted an umbrella review on the association between nurse staffing levels and NSPOs in adult acute care covering 15 included literature reviews and derived a comprehensive list of 22 NSPOs. To derive a comprehensive list of nursing-sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert opinion. Published literature reviews and their primary studies analyzing the link between nurse staffing levels and NSPOs and interviews with 16 experts on nursing care. Umbrella review and expert interviews. We screened three electronic databases for literature reviews on the association between nurse staffing levels and NSPOs. After screening 430 potentially relevant records, we included 15 literature reviews, derived a list of 22 unique NSPOs from them, and ranked these in a systematic fashion according to the strength of evidence existing for their association with nurse staffing. We extended this list of NSPOs based on data from expert interviews. Of the 22 NSPOs discussed in the 15 included literature reviews, we rated the strength of evidence for four as high, for five as moderate, and for 13 outcomes as low. Four additional NSPOs that have not been considered in literature were identified through expert interviews. We identified strong evidence for a significant association between nurse staffing levels and NSPOs. Our results may guide researchers in selecting NSPOs they might wish to prioritize in future studies. In particular, rarely studied NSPOs as well as NSPOs that were only identified through expert interviews but have not been considered in literature so far should be subject to further research. Objective: To derive a comprehensive list of nursing-sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert opinion. Data Sources/Study Setting: Published literature reviews and their primary studies analyzing the link between nurse staffing levels and NSPOs and interviews with 16 experts on nursing care. Study Design: Umbrella review and expert interviews. Data Collection/Extraction Methods: We screened three electronic databases for literature reviews on the association between nurse staffing levels and NSPOs. After screening 430 potentially relevant records, we included 15 literature reviews, derived a list of 22 unique NSPOs from them, and ranked these in a systematic fashion according to the strength of evidence existing for their association with nurse staffing. We extended this list of NSPOs based on data from expert interviews. Principal Findings: Of the 22 NSPOs discussed in the 15 included literature reviews, we rated the strength of evidence for four as high, for five as moderate, and for 13 outcomes as low. Four additional NSPOs that have not been considered in literature were identified through expert interviews. Conclusions: We identified strong evidence for a significant association between nurse staffing levels and NSPOs. Our results may guide researchers in selecting NSPOs they might wish to prioritize in future studies. In particular, rarely studied NSPOs as well as NSPOs that were only identified through expert interviews but have not been considered in literature so far should be subject to further research. KEYWORDS health workforce, hospitalization, nursing staff, patient outcome assessment, patient safety, quality of health care, systematic review What is already known on this topic * Many studies have examined the association between nurse staffing levels and nursingsensitive patient outcomes (NSPOs). * There is a high variability in methods and measurement approaches, and inconsistencies in results across primary studies. What This Study Adds * We conducted an umbrella review on the association between nurse staffing levels and NSPOs in adult acute care covering 15 included literature reviews and derived a comprehensive list of 22 NSPOs. * We provide an overview of which outcomes are used how often and used a pre-defined, systematic approach to rate the strength of evidence existing for each NSPO's association with nurse staffing. * In addition, using expert interviews, we identified four NSPOs not yet mentioned in existing literature. Objective To derive a comprehensive list of nursing‐sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert opinion. Data Sources/Study Setting Published literature reviews and their primary studies analyzing the link between nurse staffing levels and NSPOs and interviews with 16 experts on nursing care. Study Design Umbrella review and expert interviews. Data Collection/Extraction Methods We screened three electronic databases for literature reviews on the association between nurse staffing levels and NSPOs. After screening 430 potentially relevant records, we included 15 literature reviews, derived a list of 22 unique NSPOs from them, and ranked these in a systematic fashion according to the strength of evidence existing for their association with nurse staffing. We extended this list of NSPOs based on data from expert interviews. Principal Findings Of the 22 NSPOs discussed in the 15 included literature reviews, we rated the strength of evidence for four as high, for five as moderate, and for 13 outcomes as low. Four additional NSPOs that have not been considered in literature were identified through expert interviews. Conclusions We identified strong evidence for a significant association between nurse staffing levels and NSPOs. Our results may guide researchers in selecting NSPOs they might wish to prioritize in future studies. In particular, rarely studied NSPOs as well as NSPOs that were only identified through expert interviews but have not been considered in literature so far should be subject to further research. |
| Audience | Trade |
| Author | Schreyögg, Jonas Fleischer, Steffen Kreidl, Lisa Maria Blume, Kai Svane Meyer, Gabriele Dietermann, Karina Winter, Vera Kirchner‐Heklau, Uta |
| AuthorAffiliation | 3 Medical Faculty Institute for Health and Nursing Science Martin Luther University Halle‐Wittenberg Halle (Saale) Germany 2 Hamburg Center for Health Economics University of Hamburg Hamburg Germany 1 Schumpeter School of Business and Economics University of Wuppertal Wuppertal Germany |
| AuthorAffiliation_xml | – name: 1 Schumpeter School of Business and Economics University of Wuppertal Wuppertal Germany – name: 2 Hamburg Center for Health Economics University of Hamburg Hamburg Germany – name: 3 Medical Faculty Institute for Health and Nursing Science Martin Luther University Halle‐Wittenberg Halle (Saale) Germany |
| Author_xml | – sequence: 1 givenname: Kai Svane surname: Blume fullname: Blume, Kai Svane organization: University of Wuppertal – sequence: 2 givenname: Karina surname: Dietermann fullname: Dietermann, Karina organization: University of Hamburg – sequence: 3 givenname: Uta orcidid: 0000-0002-4593-4128 surname: Kirchner‐Heklau fullname: Kirchner‐Heklau, Uta organization: Martin Luther University Halle‐Wittenberg – sequence: 4 givenname: Vera orcidid: 0000-0001-7087-2400 surname: Winter fullname: Winter, Vera email: winter@wiwi.uni-wuppertal.de organization: University of Wuppertal – sequence: 5 givenname: Steffen orcidid: 0000-0003-1345-2500 surname: Fleischer fullname: Fleischer, Steffen organization: Martin Luther University Halle‐Wittenberg – sequence: 6 givenname: Lisa Maria surname: Kreidl fullname: Kreidl, Lisa Maria organization: University of Hamburg – sequence: 7 givenname: Gabriele orcidid: 0000-0002-3188-2902 surname: Meyer fullname: Meyer, Gabriele organization: Martin Luther University Halle‐Wittenberg – sequence: 8 givenname: Jonas orcidid: 0000-0001-8030-2161 surname: Schreyögg fullname: Schreyögg, Jonas organization: University of Hamburg |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33723857$$D View this record in MEDLINE/PubMed |
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| References | 2015; 13 2010; 11 2009; 46 2004; 42 2014; 70 2017; 26 2015; 71 2015; 72 2017; 27 2013; 40 2015; 52 2008; 38 2006; 36 2008; 108 2009; 151 2012; 38 2014; 29 2014; 62 2018; 43 2003; 52 2014; 23 2012; 31 2001; 20 2009; 28 2018; 17 2010; 42 2005; 19 2013; 35 2013; 50 2002; 288 2002; 346 2016; 63 2013; 158 2007; 7 2005; 6 2017 2014 2009; 361 2008; 20 2012; 68 2014; 383 2007; 45 2012; 44 2003; 21 2016; 24 2005; 35 e_1_2_8_28_1 e_1_2_8_24_1 e_1_2_8_47_1 e_1_2_8_46_1 e_1_2_8_26_1 e_1_2_8_27_1 e_1_2_8_48_1 e_1_2_8_3_1 e_1_2_8_2_1 e_1_2_8_5_1 e_1_2_8_4_1 e_1_2_8_7_1 e_1_2_8_6_1 e_1_2_8_9_1 e_1_2_8_8_1 e_1_2_8_20_1 e_1_2_8_43_1 e_1_2_8_21_1 e_1_2_8_42_1 e_1_2_8_22_1 Büscher A (e_1_2_8_35_1) 2017 e_1_2_8_45_1 e_1_2_8_23_1 e_1_2_8_44_1 e_1_2_8_41_1 Potter P (e_1_2_8_29_1) 2003; 21 Chin HL (e_1_2_8_38_1) 2013; 40 e_1_2_8_17_1 e_1_2_8_18_1 e_1_2_8_39_1 e_1_2_8_19_1 e_1_2_8_36_1 e_1_2_8_14_1 e_1_2_8_15_1 Griffiths P (e_1_2_8_40_1) 2014 e_1_2_8_16_1 e_1_2_8_37_1 Mayring P (e_1_2_8_13_1) 2014 O'Brien‐Pallas L (e_1_2_8_25_1) 2010; 42 e_1_2_8_32_1 e_1_2_8_10_1 e_1_2_8_31_1 e_1_2_8_11_1 e_1_2_8_34_1 e_1_2_8_12_1 e_1_2_8_33_1 e_1_2_8_30_1 |
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| Snippet | Objective
To derive a comprehensive list of nursing‐sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert... To derive a comprehensive list of nursing-sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert opinion.... Data Collection/Extraction Methods: We screened three electronic databases for literature reviews on the association between nurse staffing levels and NSPOs.... Objective: To derive a comprehensive list of nursing-sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert... ObjectiveTo derive a comprehensive list of nursing‐sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert... To derive a comprehensive list of nursing-sensitive patient outcomes (NSPOs) from published research on nurse staffing levels and from expert... |
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| StartPage | 885 |
| SubjectTerms | Care Quality and Safety Clinical outcomes Data collection Evaluation Extraction health workforce hospitalization Humans Interviews Interviews as Topic Literature reviews Medical care Medical care quality Medical screening Nurses Nursing Nursing care Nursing services nursing staff Nursing Staff, Hospital - statistics & numerical data Outcome Assessment, Health Care patient outcome assessment patient safety Patient Satisfaction Personnel Staffing and Scheduling - statistics & numerical data Qualitative Research Quality Indicators, Health Care Quality management quality of health care Quality of Health Care - statistics & numerical data Review Literature as Topic Staffing systematic review Workforce planning |
| Title | Staffing levels and nursing‐sensitive patient outcomes: Umbrella review and qualitative study |
| URI | https://onlinelibrary.wiley.com/doi/abs/10.1111%2F1475-6773.13647 https://www.ncbi.nlm.nih.gov/pubmed/33723857 https://www.proquest.com/docview/2582791396 https://www.proquest.com/docview/2501851335 https://pubmed.ncbi.nlm.nih.gov/PMC8522577 |
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