Browse > Article

Relationship between Nurse Staffing and Changes in Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes  

Moon, Mi-Kyung (College of Nursing, University of Iowa)
Publication Information
The Korean Journal of Rehabilitation Nursing / v.14, no.1, 2011 , pp. 62-69 More about this Journal
Abstract
Purpose: The study assessed whether nurse staffing was associated with 3 nursing sensitive outcomes used in intensive care unit (ICU) nursing care plans. Methods: This study was a retrospective and descriptive study using clinical data extracted from the data warehouse of a large acute care hospital in the Midwest. One-way analysis of variance was used to analyze the records of 578 ICU patients admitted from March 25 to May 31, 2010. Results: 79 Nursing Outcomes Classification (NOC) outcomes were used in the nursing care plans. The 3 most commonly used NOC outcomes (Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes) were analyzed to determine their relationship to nurse staffing. As a nurse staffing ratio, the skill mix of nursing caregivers ranged from 0.74 to 1 with an average of 0.90. This skill mix of nursing caregivers significantly differed among the changes in Infection Severity scores. However, the mean difference was only 0.02. Conclusion: The results did not support that greater nurse staffing was associated with better outcomes. More research is still needed to determine the usefulness of Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes in evaluating the impact of nurse staffing.
Keywords
Nursing staff; Pain; Infection; Tissue;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Head, B. J., Maas, M., & Johnson, M. (2003). Validity and community-health-nursing sensitivity of six outcomes for community health nursing with older clients. Public Health Nursing (Boston, Mass.), 20(5), 385-398.
2 Hegyvary, S. T. (1991). Issues in outcomes research. Journal of Nursing Quality Assurance, 5(2), 1-6.
3 Hickey, P., Gauvreau, K., Connor, J., Sporing, E., & Jenkins, K. (2010). The relationship of nurse staffing, skill mix, and magnet recognition to institutional volume and mortality for congenital heart surgery. The Journal of Nursing Administration, 40(5), 226-232.
4 Hugonnet, S., Uckay, I., & Pittet, D. (2007). Staffing level: A determinant of late-onset ventilator-associated pneumonia. Critical Care (London, England), 11(4), R80.
5 Hu, M. H., Hsu, S. S., Yip, P. K., Jeng, J. S., & Wang, Y. H. (2010). Early and intensive rehabilitation predicts good functional outcomes in patients admitted to the stroke intensive care unit. Disability and Rehabilitation, 32(15), 1251-1259.
6 Iezzoni, L. I. (2003). Getting started and defining terms. In L. I. Iezzoni (Ed.), Risk adjustment for measuring health care outcomes (3rd ed., pp.17-32). Chicago, IL: Health Administration Press.
7 Behrenbeck, J. G., Timm, J. A., Griebenow, L. K., & Demmer, K. A. (2005). Nursing-sensitive outcome reliability testing in a tertiary care setting. International Journal of Nursing Terminologies and Classifications: The Official Journal of NANDA International, 16(1), 14-20.
8 Buck, C. J., & American, M. A. (2010). 2010 ICD-9-CM, volumes 1&2 for physicians. Maryland Heights, Mo.: Chicago, Ill.: Saunders/Elsevier; American Medical Association.
9 Caldwell, C. L., Wasson, D., Anderson, M. A., Brighton, V., & Dixon, L.,3rd. (2005). Development of the nursing outcome (NOC) label: Hyperactivity level. Journal of Child and Adolescent Psychiatric Nursing: Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc, 18(3), 95-102.
10 Daly, J. M., Button, P., Prophet, C. M., Clarke, M., & Androwich, I. (1997). Nursing interventions classification implementation issues in five test sites. Computers, Informatics, Nursing, 15(1), 23-29.
11 Dang, D., Johantgen, M. E., Pronovost, P. J., Jenckes, M. W., & Bass, E. B. (2002). Postoperative complications: Does intensive care unit staff nursing make a difference? Heart & Lung: The Journal of Acute and Critical Care, 31(3), 219-228.
12 Pronovost, P., Dorman, T., Sadovnikoff, N., Garrett, E., Breslow, M., & Rosenfeld, B. (1999). The association between preoperative patient characteristics and both clinical and economic outcomes after abdominal aortic surgery. Journal of Cardiothoracic and Vascular Anesthesia, 13(5), 549-554.
13 Amaravadi, R. K., Dimick, J. B., Pronovost, P. J., & Lipsett, P. A. (2000). ICU nurse-to-patient ratio is associated with complications and resource use after esophagectomy. Intensive Care Medicine, 26(12), 1857-1862.
14 Stone, P. W., Larson, E. L., Mooney-Kane, C., Smolowitz, J., Lin, S. X., & Dick, A. W. (2006). Organizational climate and intensive care unit nurses' intention to leave. Clinical Care Medicine, 34(7), 1907-1912.
15 Sullivan, D. J., Carey, S. J., & Saunders, N. (1988). Identifying nursing personnel costs in a critical care unit. Nursing Administration Quarterly, 13(1), 45-53.
16 Titler, M., Dochterman, J., Xie, X., Kanak, M., Fei, Q., Picone, D. M., et al. (2006). Nursing interventions and other factors associated with discharge disposition in older patients after hip fractures. Nursing Research, 55(4), 231- 242.
17 West, E., Mays, N., Rafferty, A. M., Rowan, K., & Sanderson, C. (2009). Nursing resources and patient outcomes in intensive care: A systematic review of the literature. International Journal of Nursing Studies, 46(7), 993-1011.
18 Whitman, G. R., Kim, Y., Davidson, L. J., Wolf, G. A., & Wang, S. L. (2002). Measuring nurse-sensitive patient outcomes across specialty units. Outcomes Management, 6(4), 152-8; quiz159-60.
19 National Institute for Health and Clinical Excellence (2009). Rehabilitation after critical illness. London: National Institute for Health and Clinical Excellence. Retrieved May 30, 2011, from http://www.nice.org.uk/CG83
20 Rochester, C. L. (2009). Rehabilitation in the intensive care unit. Seminars in Respiratory and Critical Care Medicine, 30(6), 656-669.
21 Schneider, J. S., Barkauskas, V., & Keenan, G. (2008). Evaluating home health care nursing outcomes with OASIS and NOC. Journal of Nursing Scholarship: An Official Publication of Sigma Theta Tau International Honor Society of Nursing/ Sigma Theta Tau, 40(1), 76-82.
22 Stone, P. W., & Gershon, R. R. (2006). Nurse work environments and occupational safety in intensive care units. Policy Politics Nursing Practice, 7, 240-247.
23 Johnson, M., Moorhead, S., Maas, M., & Reed, D. (2003). Evaluation of the sensitivity and use of the nursing outcomes classification. Journal of Nursing Measurement, 11(2), 119-134.
24 Kalisch, B. J., Tschannen, D., & Lee, K. H. (2011). Do staffing levels predict missed nursing care? International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care/ISQua, 23(3), 302-308.
25 Moorhead, S., Johnson, M., Maas, M., & Reed, D. (2003). Testing the nursing outcomes classification in three clinical units in a community hospital. Journal of Nursing Measurement, 11(2), 171-181.
26 Keenan, G., Barkauskas, V., Stocker, J., Johnson, M., Maas, M., Moorhead, S., et al. (2003). Establishing the validity, reliability, and sensitivity of NOC in an adult care nurse practitioner setting. Outcomes Management, 7(2), 74-83.
27 Keenan, G., Stocker, J., Barkauskas, V., Johnson, M., Maas, M., Moorhead, S., et al. (2003). Assessing the reliability, validity, and sensitivity of nursing outcomes classification in home care settings. Journal of Nursing Measurement, 11(2), 135-155.
28 Maas, M., Johnson, M., Moorhead, S., Reed, D., & Sweeney, S. (2003). Evaluation of the reliability and validity of nursing outcomes classification patient outcomes and measures. Journal of Nursing Measurement, 11(2), 97-117.
29 Moorhead, S., Johnson, M., Maas, M., & Swanson, E. (Eds.) (2008). Nursing outcomes classification (NOC) (4th ed.). St.Louis, Mo.: Mosby Elsevier.
30 Head, B. J., Aquilino, M. L., Johnson, M., Reed, D., Maas, M., & Moorhead, S. (2004). Content validity and nursing sensitivity of community-level outcomes from the nursing outcomes classification (NOC). Journal of Nursing Scholarship: An Official Publication of Sigma Theta Tau International Honor Society of Nursing/Sigma Theta Tau, 36(3), 251-259.