Nurse staffing, direct nursing care hours and patient mortality in Taiwan: the longitudinal analysis of hospital nurse staffing and patient outcome study

Through stratified random sampling, a total of 108 wards selected from 32 hospitals in Taiwan were collected over a consecutive seven month period. The mixed effect logit model was used to explore the relationship between nurse staffing and patient mortality.The medians of direct-nursing-care-hour, and nurse manpower were 2.52 h, and 378 persons, respectively. The OR for death between the long direct-nursing-care-hour (> median) group and the short direct-nursing-care-hour (≦median) group was 0.393 (95% CI = [0.245, 0.617]). The OR for death between the high (> median) and the low (≦median) nurse manpower groups was 0.589 (95% CI = [0.381, 0.911]).Findings from this study demonstrate an association of nurse staffing and patient mortality and are consistent with findings from similar studies. These findings have policy implications for strengthening the nursing profession, nurse staffing, and the hospital quality associated with nursing. Additional research is necessary to demonstrate adequate nurse staffing ratios of different wards in Taiwan.The Institute of Medicine's (IOM) report "Keeping Patients Safe: Transforming the Work Environment of Nurses" indicates that low nurse staffing in hospitals is one of the causes contributing to 98,000 preventable deaths each year in the United States [1]. Physicians have also cited inadequate nurse staffing as a major impediment to providing high quality hospital care [2]. Because of an aging nurse workforce, problems with retention and difficulty with recruiting young people into the field, coupled with the severe nursing shortage seemingly will continue to exist in the U.S. [3]. Furthermore, the U.S. nursing shortage is projected to grow to 260,000 registered nurses (RN) by 2025. A shortage of this magnitude would be twice as large as any nursing shortage experienced in U.S. since the mid-1960s [4]. A large majority of hospitals in Taiwan are also short of nurses and the nurses shortage has been especially serious in recent y