Nurse
Staffing and Healthcare-Associated Infections:
A Review of the Literature
Compiled by Marguerite McMillan Jackson, PhD, RN,
FAAN
December 2001
SELECTED
REFERENCES
Page
Index
Shortage
of professional nurses
Overview
of the problem
Nursing workforce now and in the future
Strategies for recruitment and retention of professional
nurses
Health
care system influences on nurse staffing and patient outcomes
Study
Methods
Patient
outcomes
Other
Studies
of nurse staffing and patient outcomes
Infection
Morbidity/mortality
Other
Miscellaneous
Shortage
of professional nurses
Overview of the problem
Aiken LH, Blendon RJ, Rogers DE. The shortage of hospital nurses:
a new perspective. Ann Intern Med 1981;95:365-71.
Aiken LH. The nurse labor market. Am J Nurs 1983;83:1440-4.
Aiken LH. The hospital nursing shortage: a paradox of increasing
supply and increasing vacancy rates. West J Med 1989;151:87-92.
Aiken LH, Sochalski J, Anderson GF. Downsizing the hospital nursing
workforce. Health Aff (Millwood) 1996;15:88-92.
Buerhaus PI, Staiger DO, Auerbach DI. Implications of an aging registered
nurse workforce. JAMA 2000;283:2948-54.
Buerhaus PI, Staiger DO, Auerbach DI. Associate degree graduates
and the rapidly aging RN workforce. Nurs Econ 2000;18:178-84.
Buerhaus PI, Staiger DO, Auerbach DI. Why are shortages of hospital
RNs concentrated in specialty care units? Nurs Econ 2000 (18) 111-6.
Staiger DO, Buerhaus PI, Auerbach DI. Expanding career opportunities
for women and the declining interest in nursing as a career. Nurs
Econ 2000;18:230-6.
Spetz J. Hospital employment of nursing personnel: has there really
been a decline? J Nurs Adm 1998;28:20-7.
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Nursing workforce now and in the future
Aiken LH. Charting the future of hospital nursing. Image 1990;22:72-8.
Aiken LH, Salmon ME. Health care workforce priorities: what nursing
should do now. Inquiry 1994;31:318-29.
Aiken LH, Gwyther ME, Friese CR. The registered nurse workforce:
infrastructure for health care reform. Stat Bull Metrop Insur Co
1995;76:2-9.
Buerhaus PI, Staiger DO. Future of the nurse labor market according
to health executives in high managed-care areas of the United States.
Image 1997;29:313-8.
Geddes N, Salyer J, Mark BA. Nursing in the nineties: managing the
uncertainty. J Nurs Adm 1999;29:40-8.
Jackson MM. The healthcare marketplace in the next millennium and
nurses' roles in infection prevention and control. Nurs Clin North
Am 1999;34:411-26.
Peterson CA. Nursing supply and demand: is the nursing profession
facing a famine? Am J Nurs 1999;99:57-9.
Top
Strategies for recruitment and retention
of professional nurses
Aiken L. Aiken calls for novel remedies to shortage. Calif Nurse
1989;85:10-1
American Nurses Association. Principles for nurse staffing. ANA:
Washington, DC,
1999.
Buerhaus PI, Staiger DO, Auerbach DI. Policy responses to an aging
registered nurse workforce. Nurs Econ 2000;18:278-303.
Hall LM. Staff mix models: complementary or substitution roles for
nurses. Nurs Admin Quar 1997;21:31-9.
Havens DS, Aiken LH. Shaping systems to promote desired outcomes:
the magnet hospital model. J Nurs Adm 1999;29:14-20. Erratum J Nurs
Adm 1999;29:5.
McClure ML, Poulin MA, Sovie MD, Wandelt MA. Magnet hospitals: attraction
and retention of professional nurses. Washington, DC: American Academy
of Nursing, 1983.
Mills AC, Blaesing SL. A lesson from the last nursing shortage:
the influence of work values on career satisfaction with nursing.
J Nurs Adm 2000; 30(6):309-15.
Tonges MC, Rothstein H, Carter HK. Sources of satisfaction in hospital
nursing practice: a guide to effective job design. J Nurs Adm 1998;28:47-61.
Top
Health
care system influences on
nurse staffing and patient outcomes
Aiken LH, Smith HL, Lake ET. Lower Medicare mortality among a set
of hospitals known for good nursing care. Med Care 1994;32:771-87.
Aiken LH, Sochalski J, Lake ET. Studying outcomes of organizational
change in health services. Med Care 1997;35:NS6-NS18.
Aiken LH, Sloane DM, Sochalski J. Hospital organisation and outcomes.
Qual Health Care 1998;7:222-6.
Aiken LH, Clark SP, Sloane DM. Hospital restructuring: does it adversely
affect care and outcomes? J Nurs Adm 2000;30:447-65.
Aiken LH, Havens DS, Sloane DM. The Magnet Nursing Services Recognition
Program: a comparison of two groups of magnet hospitals. Am J Nurs
2000;100:26-36.
Aiken, LH, Clarke SP, Sloane DM, Sochalski JA, Busse R, Clarke H,
et al. Nurses' reports on hospital care in five countries. Health
Aff (Millwood) 2001;20:43-53.
Bethel S, Ridder J. Evaluating nursing practice: satisfaction at
what cost? Nurs Manage 1994;24:41-8.
Bloom JR, Alexander J, Nuchols BA. Nurse staffing patterns and hospital
efficiency in the United States. Social Sci Med 1997;44:147-55.
Brewer CS, Frazier P. The influence of structure, staff type, and
managed-care indicators on registered nurse staffing. J Nurs Adm
1998;28:28-36.
Buerhaus PI, Staiger DO. Managed care and the nurse workforce. JAMA
1996;276:1487-93.
Corey-Lisle P, Tarzian AJ, Cohen MZ, Trinkoff AM. Healthcare reform:
its effects on nurses. J Nurs Adm 1999;29:30-7.
Ingersoll GL, Cook J-A, Fogel S, Applegate M, Frank B. The effect
of patient-focused redesign on midlevel nurse managers' role responsibilities
and work environment. J Nurs Adm 1999;29:21-7.
Institute of Medicine. Nursing staff in hospitals and nursing homes:
is it adequate? National Academy Press, Washington, DC, 1996.
Li J, Birkhead GS, Strogatz DS, et al. Impact of institution size,
staffing patterns, and infection control practices on communicable
disease outbreaks in New York State nursing homes. Am J Epidemiol
1996;143:1042-9.
Sochalski J, Aiken LH. Accounting for variation in hospital outcomes:
a cross-national study. Health Aff 1999;18:256-9.
Sovie MD, Jawad AF. Hospital restructuring and its impact on outcomes:
nursing staff regulations are premature. J Nurs Adm 2001;31:588-600.
Van Servellen
G, Schultz MA. Demystifying the influence of hospital characteristics
on inpatient mortality rates. J Nurs Adm 1999;29:39-47.
Top
Study
methods
Patient
outcomes
American Nurses Association. Nursing quality indicators: definitions
and implications. ANA: Washington, DC, 1996.
Cho S-H. Nurse staffing and adverse patient outcomes: a systems
approach. Nurs Outlook 2001;49:780-5.
Larson E, Oram LF, Hedrick E. Nosocomial infection rates as an indicator
of quality. Med Care 1988;26:676-84.
Maas ML, Johnson
M, Moorhead S. Classifying nursing-sensitive patient outcomes. Image
1996;28:295-301.
Mark BA, Burleson DL. Measurement of patient outcomes: data availability
and consistency across hospitals. J Nurs Adm 1995;25:52-9.
Minnich AF, Pabst MK. Improving the ability to detect the impact
of labor on patient outcomes. J Nurs Adm 1998;28:17-21.
Reed L, Blegen MA, Goode CS. Adverse patient occurrences as a measure
of nursing care quality. J Nurs Adm 1998;28:62-9.
Sochalski J, Aiken LH, Fagin CM. Hospital restructuring in the United
States, Canada, and Western Europe: an outcomes research agenda.
Med Care 1997;35:OS13-OS25.
Pierce SF. Nurse-sensitive health care outcomes in acute care settings:
an integrative analysis of the literature. Care Qual 1997;11:60-72.
Price J, Ekleberry A, Grover A, Melendy S, Baddam K, McMahon J,
et al. Evaluation of clinical practice guidelines on outcome of
infection in patients in the surgical intensive care unit. Crit
Care Med 1999;27:2118-24.
Top
Other
Aiken LH, Fagin CM. Evaluating the consequences of hospital restructuring.
Med Care 1997;35:0S1-0S4.
Aiken LH, Sochalski J, Lake ET. Studying outcomes of organizational
change in health services. Med Care 1997;35:NS6-NS18.
Scott JG, Sochalski J, Aiken LH. Review of magnet hospital research:
findings and implications for professional nursing practice. J Nurs
Adm 1999;29:9-19.
Top
Studies
of nurse staffing and patient outcomes
Infection
Archibald LK, Manning ML, Bell LM, Banerjee SN, Jarvis WR. Patient
density, nurse-to-patient ratio and nosocomial infection risk in
a pediatric cardiac intensive care unit. Pediatr Infect Dis J 1997;16:1045-8.
Arnow PM, Allyn PA, Nichols EM, Hill DL, Pezzlo M, Bartlett RH.
Control of methicillin-resistant Staphylococcus aureus in a burn
unit: role of nurse staffing. J Trauma 1982;22:954-9.
Blegen MA, Goode CJ, Reed L. Nurse staffing and patient outcomes.
Nurs Res 1998;47:43-50.
Farrington M., Trundle C, Redpath C, Anderson L. Effects on nursing
workload of different methicillin-resistant Staphylococcus aureus
(MRSA) control strategies. J Hosp Infect 2000;46:118-23.
Fridkin SK,
Pear SM, Williamson TH, Galgiani JN, Jarvis WR. The role of understaffing
in central venous catheter-associated bloodstream infections. Infect
Control Hosp Epidemiol 1996;17:147-9.
Goldman DA, Durbin WA Jr, Freeman J. Nosocomial infections in a
neonatal intensive care unit. J Infect Dis 1981;144:449-59.
Haley RW, Bregman DA. The role of understaffing and overcrowding
in recurrent outbreaks of staphylococcal infections in neonatal
special-care units. J Infect Dis 1982;145:875-85.
Haley RW, Cushion NB, Tenover FC, Bannerman TL, Dryer D, Ross J,
et al. Eradication of endemic methicillin-resistant Staphylococcus
aureus infections from a neonatal intensive care unit. J Infect
Dis 1995;171:614-24.
Haley RW, Hightower AW, Khabbaz RF, Thornsberry C, Martone WJ, Allen
JR, et al. The emergence of methicillin-resistance Staphylococcus
aureus infections in United States hospitals: possible role of the
house staff-patient transfer circuit. Ann Intern Med 1982;97:297-308.
Harbarth S, Sudre P, Dharan S, Cadenas S, Pittet D. Outbreak of
Enterobacter cloacae related to understaffing, overcrowding, and
poor hygiene practices. Infect Control Hosp Epidemiol 1999;20:598-603.
Isaacs D, Catterson J, Hope PL, Moxon ER, Wilkinson AR. Factors
influencing colonisation with gentamicin resistant gram negative
organisms in the neonatal unit. Arch Dis Child 1988;63:533-5.
Kovner C, Gergen P. Nurse staffing levels and adverse events following
surgery in U.S. hospitals. Image 1998;30:315-21.
Robert J, Fridkin SK, Blumberg HM, Anderson B, White N, Ray SM,
et al. The influence and composition of the nursing staff on primary
bloodstream rates in surgical intensive care unit. Infect Control
Hosp Epidemiol 2000;21:12-7.
Moisiuk SE, Robson D, Klass L, Kliewer G, Wasyliuk W, Davi M, et
al. Outbreak of parainfluenza virus type 3 in an intermediate care
nursery. Pediatr Infect Dis J 1998;17:49-53.
Vicca AF. Nursing staff workload as a determinant of methicillin-resistant
Staphylococcus aureus spread in an adult intensive therapy unit.
J Hosp Infect 1999;43:109-13.
Top
Morbidity/mortality
Flood SD, Diers D. Nurse staffing, patient outcome and cost. Nursing
Management 1988;19(5):34-43.
Giraud T,
Dhainaut J, Vaxelaire J, Joseph T, Journois D, Bleichner G, et al.
Iatrogenic complication in adult intensive care units: a prospective
two-center study. Crit Care Med 1993;21:40-51.
Gittell JH,
Fairfield KM, Bierbaum B, Head W, Jackson R, Kelly M, et al. Impact
of relational coordination on quality of care, postoperative pain
and functioning, and length of stay: a nine-hospital study of surgical
patients. Med Care 2000;38:807-19.
Tarnow-Mordi WO, Hau C, Warden A, Shearer AJ. Hospital mortality
in relation to staff workload: a 4-year study in an adult intensive
care unit. Lancet 2000;356:185-9.
Silber JH, Williams SV, Krakauer H, Schwartz JS. Hospital and patient
characteristics associated with death after surgery: a study of
adverse occurrence and failure to rescue. Med Care 1992;30:615-29.
Top
Other
American Nurses Association. Implementing nursing's report card:
a study of RN staffing, length of stay and patient outcomes. American
Nurses Publishing: Washington, DC, 1998.
American Nurses Association. Nurse staffing and patient outcomes
in the inpatient hospital setting. ANA: Washington, DC, 2000.
Blegen MA, Vaughn T. A multisite study of nurse staffing and patient
occurrences. Nurs Econ 1998;16(4):196-203.
Hunt J, Hagen S. Nurse to patient ratios and patient outcomes. Nurs
Times 1998 (Nov 11-17);94(45):63-6.
McCloskey JM. Nurse staffing and patient outcomes. Nurs Outlook
1998;46(5):199-200.
Needleman J, Buerhaus PI, Mattke S, Stewart M, Zelevinsky K. Nurse
Staffing and Patient Outcomes in Hospitals. Final Report: US Department
of Health and Human Services, Health Resources and Services Administration,
Contract No. 230-99-0021. February 28, 2001.
Rowell PA,
Milholland DK. Nursing and threats to patient and nurse safety and
quality of patient care. J Nurs Care Qual 1998;12:9-13.
Top
Miscellaneous
American Nurses Association. Nursing care report card for acute
care. ANA: Washington, DC, 1995.
American Nurses Association. Implementing nursing's report card.
ANA: Washington, DC, 1997.
Goldrich BA, Turner JG. Education and behavior change in prevention
and control of infection. IN: Soule BM, Larson EL, Preston GA (eds).
Infections and nursing practice: prevention and control. St. Louis:
CV Mosby, 1995, 175-92.
Jackson MM, Massanari RM. Reengineering and infection control programs:
commentary and a case study. Am J Infect Control 2000.28:44-50.
Kramer M, Hafner LP. Shared values: impact on staff nurse job satisfaction
and perceived productivity. Nurs Res 1989;38:172-7.
Kupperschmidt BR. Understanding generation X employees. J Nurs Adm
1998;28(12):36-43.
Mitchell PH, Shortell SM. Adverse outcomes and variations of care
delivery. Med Care 1997;35:NS19-NS32.
O'Boyle CA, Henly SJ, Larson E. Understanding adherence to hand
hygiene recommendations: the theory of learned behavior. Am J Infect
Control 2001;29:352-60.
Pettinger A, Nettleman M. Epidemiology of isolation precautions.
Infect Control Hosp Epidemiol 1991;12:303-7.
Pittet D,
Mourouga P, Perneger T, & members of the infection control program.
Compliance with handwashing in a teaching hospital. Ann Intern Med
1999;130:126-30.
Rothschild
JS. What's happening to patient care? Final results of the AJN Survey.
Am J Nurs 1996;11:24-39.
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