TableĀ 3

ORs indicating the association of nursing skill mix with inpatient mortality, patient ratings of their hospitals, nurse-reported quality of care and nurse outcomes in hospitals in six European countries

ORs reflecting the associations of skill mix with the different outcomes
Without controlsWith controls
OutcomeOR 95% CIp ValueOR 95% CIp Value
30-day inpatient mortality0.90 (0.81 to 1.00)0.0580.89 (0.80 to 0.98)0.018
Low hospital rating by patients0.81 (0.74 to 0.88)<0.0010.90 (0.81 to 0.99)0.026
Poor/fair unit quality0.90 (0.81 to 1.00)0.0530.89 (0.80 to 0.98)0.016
Poor/failing safety grade1.05 (0.93 to 1.17)0.4570.85 (0.73 to 0.99)0.040
Poor safety culture1.09 (1.01 to 1.15)0.0220.93 (0.87 to 0.99)0.027
Nurse would not recommend hospital0.97 (0.87 to 1.08)0.6160.82 (0.72 to 0.93)0.001
Pressure ulcers0.82 (0.74 to 0.91)0.0010.85 (0.73 to 0.98)0.027
Falls with injury0.89 (0.79 to 1.00)0.0580.80 (0.71 to 0.91)0.001
Urinary tract infections0.89 (0.83 to 0.96)0.0020.88 (0.78 to 1.00)0.049
High nurse burnout0.93 (0.85 to 1.01)0.1020.89 (0.80 to 1.00)0.043
Nurse job dissatisfaction0.87 (0.79 to 0.95)0.0030.91 (0.83 to 0.99)0.025
  • Inpatient mortality was measured using patient discharge data, hospital rating by patients was measured using patient survey data and the remainder were measured using nurse survey data. Huber-White Cluster corrections were used to estimate SEs associated with the skill mix coefficients. Skill mix was measured in units of 10 percentage points. Controls in the mortality models include hospital characteristics (total bedside care staffing, nurse education, teaching status, high technology and bed size), patient characteristics (age, sex, admission type, 43 dummy variables indicating surgery type and 17 dummy variables indicating comorbidities present on admission) and country. Controls in the models estimating patient ratings included the same hospital characteristics and country. Controls in the models estimating nurse-reported outcomes included hospital characteristics (total nursing personnel staffing, nurse practice environment, teaching status, high technology and bed size) nurse characteristics (age, sex, full-time employment status and unit specialty) and country.