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Impact of nursing on hospital patient mortality: a focused review and related policy implications
  1. A E Tourangeau1,
  2. L A Cranley2,
  3. L Jeffs3
  1. 1Faculty of Nursing, University of Toronto and Institute for Clinical Evaluative Sciences in Ontario, Toronto, Ontario, Canada
  2. 2Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
  3. 3Department of Health Policy Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to:
 DrA E Tourangeau
 Assistant Professor, Faculty of Nursing, University of Toronto, 215-155 College Street, Toronto, Ontario, Canada M5T 1P8; ann.tourangeau{at}


Understanding the determinants of patient mortality can lead to the development of strategies that reduce mortality and prevent unnecessary death. This paper synthesizes the body of published research that explores determinants of mortality for patients who have experienced acute care hospitalization. Fifteen research manuscripts were found to meet the selection criteria through an electronic search in MEDLINE and CINAHL (1986–2004). Seven categories of determinants of mortality were found: nurse-physician relationships, nurse staffing characteristics, physician characteristics, professional practice environment, nurse experience, registered nurse educational preparation, and clinical nursing support. Implications and recommendations for improving quality and safety in hospital care are discussed.

  • mortality
  • patient safety
  • policy
  • nurse staffing

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  • Ann Tourangeau is supported by the Career Scientist program of the Ontario Ministry of Health and Long-term Care. Lisa Cranley is supported by a Doctoral Fellowship from the Canadian Institutes of Health Research.

  • The authors declare no competing interests.