ArticleCritical care medicine2018
Patient Outcomes After the Introduction of Statewide ICU Nurse Staffing Regulations.
Article in Critical care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review.Journal of advanced nursing · 2021Pooled it
- Impact of Nurse Staffing Policy on Nurse Outcomes in Intensive Care Units: A National Longitudinal Study in the United States.Nursing in critical care · 2026Article
- Evaluating the Resilience of ICU Nurse Staffing Standard Operating Procedures Under Demand Variability: A Discrete Event Simulation Study Using MIMIC-IV.Healthcare (Basel, Switzerland) · 2026Article
- Article
- Optimizing Pharmacist Team-Integration for ICU Patient Management: Rationale, Study Design, and Methods for a Multicentered Exploration of Pharmacist-to-Patient Ratio.Critical care explorations · 2023Article
- Relationship between work engagement and healthy work environment among Chinese ICU nurses: The mediating role of psychological capital.Nursing open · 2023Article
- Familiarity Among Nurses: The Key to ICU Patient Outcomes?American journal of respiratory and critical care medicine · 2023Article
- The Relationship of Nurse and Physician Staffing in Intensive Care Units with Patient Outcomes in Postoperative Patients on Ventilators: An Analysis Using Korean National Health Insurance Data.Healthcare (Basel, Switzerland) · 2023Article
- MRI and the Critical Care Patient: Clinical, Operational, and Financial Challenges.Critical care research and practice · 2023Review
- Hospital Variation in Management and Outcomes of Acute Respiratory Distress Syndrome Due to COVID-19.Critical care explorations · 2022Article
- Workforce and Task Sharing of Nurses in the Japanese Intensive Care Unit-Cross-Sectional Postal Survey.Healthcare (Basel, Switzerland) · 2021Article
- Physical Rehabilitation in Critically Ill Children: A Multicenter Point Prevalence Study in the United States.Critical care medicine · 2020Article
- Development and use of an adjusted nurse staffing metric in the neonatal intensive care unit.Health services research · 2020Article
- [Hospital nursing personnel staffing and patient outcome].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2020Review
- The Structure of Critical Care Nursing Teams and Patient Outcomes: A Network Analysis.American journal of respiratory and critical care medicine · 2020Article
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Abstract
objectivesTo assess whether Massachusetts legislation directed at ICU nurse staffing was associated with improvements in patient outcomes.
designRetrospective cohort study; difference-in-difference design to compare outcomes in Massachusetts with outcomes of other states (before and after the March 31, 2016, compliance deadline).
settingAdministrative claims data collected from medical centers across the United States (Vizient). PATIENTS: Adults between 18 and 99 years old who were admitted to ICUs for greater than or equal to 1 day.
interventionsMassachusetts General Law c. 111, § 231, which established 1) maximum patient-to-nurse assignments of 2:1 in the ICU and 2) that this determination should be based on a patient acuity tool and by the staff nurses in the unit. MEASUREMENTS AND MAIN
resultsNurse staffing increased similarly in Massachusetts (n = 11 ICUs, Baseline patient-to-nurse ratio 1.38 ± 0.16 to Post-mandate 1.28 ± 0.15; p = 0.006) and other states (n = 88 ICUs, Baseline 1.35 ± 0.19 to Post-mandate 1.31 ± 0.17; p = 0.002; difference-in-difference p = 0.20). Massachusetts ICU nurse staffing regulations were not associated with changes in hospital mortality within Massachusetts (Baseline n = 29,754, standardized mortality ratio 1.20 ± 0.04 to Post-mandate n = 30,058, 1.15 ± 0.04; p = 0.11) or when compared with changes in hospital mortality in other states (Baseline n = 572,952, 1.15 ± 0.01 to Post-mandate n = 567,608, 1.09 ± 0.01; difference-in-difference p = 0.69). Complications (Massachusetts: Baseline 0.68% to Post-mandate 0.67%; other states: Baseline 0.72% to Post-mandate 0.72%; difference-in-difference p = 0.92) and do-not-resuscitate orders (Massachusetts: Baseline 13.5% to Post-mandate 15.4%; other states: Baseline 12.3% to Post-mandate 14.5%; difference-in-difference p = 0.07) also remained unchanged relative to secular trends. Results were similar in interrupted time series analysis, as well as in subgroups of community hospitals and workload intensive patients receiving mechanical ventilation.
conclusionsState regulation of patient-to-nurse staffing with the aid of patient complexity scores in intensive care was not associated with either increased nurse staffing or changes in patient outcomes.
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