Table 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 controls		With controls
Outcome	OR 95% CI	p Value	OR 95% CI	p Value
30-day inpatient mortality	0.90 (0.81 to 1.00)	0.058	0.89 (0.80 to 0.98)	0.018
Low hospital rating by patients	0.81 (0.74 to 0.88)	<0.001	0.90 (0.81 to 0.99)	0.026
Poor/fair unit quality	0.90 (0.81 to 1.00)	0.053	0.89 (0.80 to 0.98)	0.016
Poor/failing safety grade	1.05 (0.93 to 1.17)	0.457	0.85 (0.73 to 0.99)	0.040
Poor safety culture	1.09 (1.01 to 1.15)	0.022	0.93 (0.87 to 0.99)	0.027
Nurse would not recommend hospital	0.97 (0.87 to 1.08)	0.616	0.82 (0.72 to 0.93)	0.001
Pressure ulcers	0.82 (0.74 to 0.91)	0.001	0.85 (0.73 to 0.98)	0.027
Falls with injury	0.89 (0.79 to 1.00)	0.058	0.80 (0.71 to 0.91)	0.001
Urinary tract infections	0.89 (0.83 to 0.96)	0.002	0.88 (0.78 to 1.00)	0.049
High nurse burnout	0.93 (0.85 to 1.01)	0.102	0.89 (0.80 to 1.00)	0.043
Nurse job dissatisfaction	0.87 (0.79 to 0.95)	0.003	0.91 (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.