Table 3.

Longitudinal and Cross-Sectional Odds-Ratios (OR) and 95% Confidence Intervals (CI) for the Regressions of Three Quality of Care Indicators and Three Patient Safety Indicators on Each of Three Nursing Resources

Nursing Resources		Quality of Care Indicators			Patient Safety Indicators
Nursing Resources		Rate Quality Poor or Fair	Not Confident Patients Can Manage Care After Discharge	Not Confident Management Will Resolve Patient Care Problems	Rate Patient Safety as C,D, or F	Worry That Mistakes Are Held Against Them	Do Not Feel Free to Question Authority
Nurse Work Environment
Longitudinal Association - Hospital Level ( $e x p β_{2})$	OR	0.82^***	0.97	0.84^***	0.85^***	0.94^**	0.96*
	CI	[0.76,0.87]	[0.93,1.02]	[0.80,0.88]	[0.81,0.90]	[0.90,0.99]	[0.92,1.00]
Cross-Sectional Association - Hospital Level ( $e x p β_{3}$ )	OR	0.72^***	0.84^***	0.81^***	0.78^***	0.91^***	0.98
	CI	[0.69,0.76]	[0.81,0.88]	[0.78,0.84]	[0.75,0.81]	[0.88,0.94]	[0.95,1.01]
Cross-Sectional Association - Individual Level (exp $β_{1}$ )	OR	0.23^***	0.46^***	0.24^***	0.23^***	0.50^***	0.46^***
	CI	[0.22,0.24]	[0.45,0.47]	[0.23,0.25]	[0.22,0.24]	[0.49,0.52]	[0.45,0.47]

Nurse Staffing
Longitudinal Association - Hospital Level ( $e x p β_{2})$	OR	1.04	1.04*	1.05^**	1.04*	1.05^**	1.04^**
	CI	[1.00,1.09]	[1.00,1.07]	[1.02,1.08]	[1.01,1.08]	[1.01,1.08]	[1.01,1.07]
Cross-Sectional Association - Hospital Level ( $e x p β_{3}$ )	OR	1.07^**	1.06^**	1.03	1.05*	1.02	1.06^***
	CI	[1.02,1.12]	[1.02,1.10]	[0.99,1.07]	[1.01,1.09]	[0.99,1.06]	[1.03,1.09]
Cross-Sectional Association - Individual Level (exp $β_{1}$ )	OR	1.04^***	1.03^***	1.02^***	1.04^***	1.02^***	1.02^***
	CI	[1.03,1.04]	[1.03,1.04]	[1.02,1.03]	[1.03,1.04]	[1.01,1.02]	[1.01,1.02]

Nurse Education
Longitudinal Association - Hospital Level ( $e x p β_{2})$	OR	0.93^**	0.97*	0.96*	0.96	1.03	1.00
	CI	[0.88,0.98]	[0.93,1.00]	[0.92,0.99]	[0.92,1.00]	[1.00,1.06]	[0.97,1.03]
Cross-Sectional Association - Hospital Level ( $e x p β_{3}$ )	OR	0.92^***	0.92^***	0.91^***	0.94^***	0.97^**	0.91^***
	CI	[0.88,0.97]	[0.89,0.95]	[0.88,0.94]	[0.90,0.97]	[0.94,0.99]	[0.88,0.93]
Cross-Sectional Association - Individual Level (exp $β_{1}$ )	OR	0.95	0.99	0.90^***	0.93^**	0.95*	0.92^***
	CI	[0.89,1.01]	[0.94,1.03]	[0.86,0.94]	[0.89,0.98]	[0.91,0.99]	[0.88,0.95]

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.

Notes: For each of the six dependent variables--three Quality of Care Indicators and three Patient Safety Indicators--there is a separate regression corresponding to each of the three Nursing Resource variables. As per the text equation, the association of these Nursing Resource variables with each indicator is decomposed at the hospital level into a longitudinal (β₂) and a cross-sectional effect (β₃), and the individual- (nurse-level) association between evaluation of resources and indicators (β₁) is also shown. All regressions control for measurement occasion (first or second survey), state, and selected nurse (age, age-squared, sex, unit type of specialty [medical/surgical, ICU, or other], and education [in the models for Work Environment and Staffing]) and hospital (number of beds, teaching status, and technology) characteristics. Single, double, and triple asterisks indicate associations that are significant at the .05, .01, and .001 levels, respectively. Longitudinal associations that are significant at the .05 level or higher are also shaded.