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Systematic Review

The effect of nurse staffing on clinical outcomes of children in hospital: a systematic review.

Wilson S, Bremner A, Hauck Y, Finn J. The effect of nurse staffing on clinical outcomes of children in hospital: a systematic review. International Journal of Evidence-Based Healthcare 2011 9 (2):97-121. [PubMed]

Sources of funding: None stated. Conflict of interest not stated.

Main author affiliation: Wilson S, School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia.

Q: Is there an association between nurse staffing and clinical outcomes in hospitalized children?

BACKGROUND

The objective of this review was to identify any association between nurse staffing and clinical outcomes in hospitalised children. Measures of nurse staffing considered include: nursing hours per patient day, nurse-to-patient ratio, skill mix, nurse education level, nurse experience, agency/casual nursing hours of care, and staff turnover.

INCLUSION

Individual studies from systematic review

SEARCH FOR EVIDENCE: For the period January 1993 to February 2010

INCLUDED STUDIES: 8 studies (10 papers)

STUDIES RELATED TO PRESCRIBING: 2

STUDY DESIGN: CT, CBA, BA.

STUDY CHARACTERISTICS:

  • Target Population: Nurses.
  • Intervention(s): Skill mix changes
  • Setting: Location - Hospitals; Ownership - Public, Other (Not specified); Institution - Not specified.
  • Patients Reviewed: Age - Children; Diagnosis/Clinical condition - Not specified.
  • Drug Related Outcome Categories: Drug safety (medication administration error).
  • Other Outcome Categories: None.

AUTHORS' ANALYSIS OF DATA:

Effect sizes, descriptive

REVIEW QUALITY: 5

RESULTS - OVERALL

See below.

RESULTS - RELATED TO PRESCRIBING

None of the included studies were RCTs. Skill mix changes (n=3) had no effect on improving prescribing related behaviour (n=2). We excluded 6 studies from our analysis as they were beyond the scope of this project.

CONCLUSIONS - OVERALL

See below.

CONCLUSIONS - RELATED TO PRESCRIBING

Medium quality review. Too few studies were located to make conclusions on prescribing related outcomes.

RELATED INTERVENTIONS


Table of Results

Comparison Outcome N Analysis Results
Skill mix changes vs control Appropriate use - drug safety 2 Vote counting by direction of effect and statistical significance Vote counting 0/2 studies favoured intervention: no effect.