The association between nurse staffing and hospital outcomes in injured patients

Table 6 Odds ratios estimating the association between nurse staffing and individual hospital-associated infections

	Unadjusted^c(95% CI)	P Value	Adjusted^d(95% CI)	P Value
Sepsis
RN staffing^a	1.00 (0.97, 1.03)	0.97	1.01 (0.99, 1.03)	0.37
LPN staffing^{a e}	0.98 (0.87, 1.10)	0.77	1.27 (1.11, 1.45)	<0.001
Nurses' Aide staffing^a	0.97 (0.93, 1.01)	0.113	1.00 (0.96, 1.03)	0.81
% Ratio of LPN to Total Nursing^b	1.00 (0.97, 1.03)	0.99	1.06 (1.03, 1.10)	<0.001
Total Nursing Time^b	1.00 (0.90, 1.11)	0.96	1.07 (1.00, 1.14)	0.07
Pneumonia
RN staffing	1.01 (0.97, 1.05)	0.74	1.03 (0.99, 1.07)	0.17
LPN staffing	0.78 (0.61, 0.99)	0.043	1.00 (0.78, 1.30)	0.98
Nurses' Aide staffing	0.95 (0.89, 1.01)	0.096	0.92 (0.87, 0.98)	0.006
% Ratio of LPN to Total Nursing	0.94 (0.88, 0.99)	0.02	0.99 (0.93, 1.06)	0.86
Total Nursing Time	1.00 (0.84, 1.18)	0.97	1.10 (0.95, 1.30)	0.18
Staphylococcus infections
RN staffing	1.01 (0.99, 1.04)	0.21	1.02 (1.00, 1.05)	0.056
LPN staffing	1.02 (0.86, 1.21)	0.81	1.15 (0.98, 1.36)	0.083
Nurses' Aide staffing	0.96 (0.93, 1.00)	0.064	0.98 (0.93, 1.02)	0.32
% Ratio of LPN to Total Nursing	0.97 (0.95, 1.04)	0.91	1.03 (0.99, 1.07)	0.19
Total Nursing Time	1.06 (0.96, 1.17)	0.25	1.10 (1.00, 1.21)	0.04
Clostridium difficile infections
RN staffing	0.97 (0.94, 1.01)	0.16	0.99 (0.96, 1.02)	0.54
LPN staffing	0.73 (0.56, 0.94)	0.014	0.83 (0.65, 1.07)	0.15
Nurses' Aide staffing	1.01 (0.95, 1.07)	0.76	1.00 (0.95, 1.06)	0.98
% Ratio of LPN to Total Nursing	0.94 (0.87, 1.02)	0.12	0.96 (0.90, 1.02)	0.19
Total Nursing Time	0.87 (0.76, 1.01)	0.07	0.94 (0.82, 1.08)	0.19

^a results based on model which included RN staffing and LPN staffing as nurse staffing measures.
^b results based on model which included staffing ratio and total nurse staffing as measures of nurse staffing.
^c In the unadjusted analyses, only the nurse staffing measures were included in the regression models.
^d adjusted for patient demographics, injury severity, mechanism of injury, comorbidities, and hospital characteristics (teaching status, trauma center status, hospital ownership, hospital bed size, technology, geographic region).
^e staffing is in 15-minute increments per patient day (0.25 HPPD).

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