Table 1.
Survey Questions and Codes Used to Measure the Independent Variables (Nursing Resources) in the Analyses, at the Nurse-Level and Hospital-Level, with Distributions in 2006 and 2016.
| Nursing Resource Measures | Survey Question | Variable Coding at the Nurse Level |
Mean (and SD) or Percent 2006 |
Mean (and SD) or Percent 2016 |
|---|---|---|---|---|
| Nurse Level |
||||
| Nurse Work Environment | How would you rate the work environment of your job? | 1 = Poor; 2 = Fair; 3 = Good; 4 = Excellent |
= 2.7 σ = (.0.8) |
= 2.8 σ = (0.8) |
| Nurse Staffing | How many patients were assigned to you on your last shift? | 1 = 1 Patient; 2 = 2 Patients; etc. |
= (5.2) σ = (5.4) |
= (4.5) σ = (5.4) |
| Nurse Education | What is your highest level of education completed in nursing? | 1 = BSN or Higher; 0 = Diploma or AD |
44.2% | 60.1% |
| Hospital Level | Description of Hospital-Level Measures | Hospital-Level Mean (and SD) in 2006 | Hospital-Level Mean (and SD) in 2016 | |
| Nurse Work Environment | Nurse-level work environment scores were averaged across all nurses in each hospital, and standardized, so that coefficients can be interpreted as reflecting the cross-sectional differences across hospitals, or longitudinal changes within hospitals, produced by a shift in the work environment of one standard deviation. |
= 2.7 σ = (0.3) |
= 2.8 σ = (0.3) |
|
| Nurse Staffing | Two questions were used, which asked nurses 1) how many patients were cared for on their unit on their last shift, and 2) how many nurses were on that unit on that shift to provide their care. We averaged these across all nurses in each hospital, and divided the average number of patients reported by the nurses by the average number of nurses that were reported to have provided their care. The resulting coefficients can be interpreted as reflecting the cross-sectional differences across hospitals, or longitudinal changes within hospitals, produced by an average increase of one patient per nurse. |
= 5.3 σ = (1.4) |
= 4.7 σ = (1.5) |
|
| Nurse Education | Nurse education was measured at the hospital level by calculating the proportion of nurse with BSN degrees or higher, and multiplying the proportions by 100 so the coefficients can be interpreted as reflecting the cross-sectional differences across hospitals, or longitudinal changes within hospitals, produced by a 10-point increase in the percentage of BSN nurses. |
= 41.3% σ = (12.5%) |
= 56.3% σ = (15.4%) |
|
Source: The survey data are from the 2006 Multi-State Nursing Care and Patient Safety Study and the 2016 RN4CAST-U.S. Panel Study of Effects of Changes in Nursing on Patient Outcomes, conducted by the Center for Health Outcomes at the University of Pennsylvania. 35,228 hospital nurses from 737 hospitals completed the surveys in 2006, and 21,696 nurses from these hospitals completed the surveys in 2016.