Aiken, L., Cimiotti, J., Sloane, D., Smith, H., Flynn, L., & Neff, D. (2011). Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Medical Care, 49(12), 1047-1053.
This study was conducted to determine the conditions under which the impact of hospital nurse staffing , nurse education, and work environment are associated with patient outcomes. Evidence suggests that lower patient-to-nurse ratios, higher proportion of nurses with a baccalaureate level education, and better nurse work environments are associated individually and additively with lower mortality and failure-to-rescue. This study reveals the conditional circumstances under which particular nursing investments yield the best outcomes. Results suggest that nursing characteristics sometimes need to be considered in combination to improve quality and safety. Higher patient-to-nurse ratios increase the odds on patient deaths and failures to rescue, whereas better work environments and higher percentages of BSN nurses decrease those odds.
McHugh, M., Kelly, L., Smith, H., Wu, E., Vanak, J., & Aiken, L. (2013). Lower mortality in magnet hospitals. Medical Care, 51(5), 382-388.
This study aimed to determine whether magnet hospitals have lower mortality and failure-to-rescue compared with non-magnet hospitals and to determine the most likely explanations. Findings suggest that magnet hospital had signficiantly better work environments and higher proportions of nurses with bachelor’s degress and specialty certification. These nursing factors explained much of the magnet hospital effect on patient outcomes including decreased mortality and failure to rescue.
Aiken, L. H., Sloane, D. M., Cimiotti, J. P., Clarke, S. P., Flynn, L., Seago, J. A., Spetz, J. and Smith, H. L. (2010). Implications of the California Nurse Staffing Mandate for Other States. Health Services Research, 45: 904–921.
Rafferty, A.M, Clarke, S.E, Coles, J., Ball, J., James, P., McKee, M., & Aiken, L. (2007). Outcomes of variation in hospital nurse staffing in English hospitals. Cross-sectional analysis of survey data and discharge records. International Journal of Nursing Studies, 44(2), 175-182.
Sales, A. et al. (2008). The association between nursing factors and patient mortality in the Veterans Health Administration: The view from the nursing unit level. Medical Care, 46(9), 938-945.
Van den Heede, K., Lesaffre, E., Diya, L., Vleugels, A., Clarke, S.P., Aiken, L.H., & Sermeus, W. (2009). The relationship between inpatient cardiac surgery mortality and nurse numbers and educational level: Analysis of administrative data. International Journal of Nursing Studies, 46, 796-803.