Nurse work environments affect patient outcomes, study finds

Surgical patients treated in hospitals with good work environments for nurses are less likely to require intensive care or die, according to a study published Dec. 15 in AACN Advanced Critical Care.

Researchers analyzed data on 269,764 adult Medicare patients who had general, orthopedic or vascular surgical procedures between January 2006 and October 2007 at 453 hospitals nationwide. A 2006 survey of registered nurses provided data on work environments, and an annual survey from the American Hospital Association provided data on hospital characteristics. They used logistic regression models to estimate how nurses' work environments affected the odds of patients' admission to the intensive care unit and death rates.

Four things to know:

1. Patients undergoing surgery in hospitals with good nurse work environments had a 16 percent lower chance of being admitted to the ICU compared to patients in hospitals with mixed or poor nurse work environments.

2. The in-hospital and 30-day mortality rates were also 12 percent and 11 percent lower, respectively, for patients treated in hospitals with good nurse work environments. 

3. Overall, patients treated in good work environments had a 15 percent lower risk of either ICU admission or death within 30 days of admission. 

4. Researchers said the study is among the first to directly link nurse work environments to ICU use. The findings suggest efforts to improve nurses' work environments could help reduce ICU utilization and improve patient outcomes. 

View the full study here.

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