How Organizational Inclusion Shapes Patient Satisfaction in Magnet Hospitals.

Objective: Magnet hospitals exhibit higher patient satisfaction than non-Magnet hospitals, yet the underlying mechanisms driving these differences remain underexplored. This study examined the associations between Magnet status, hospitals' inclusion efforts for diverse populations, and patient satisfaction, and whether inclusion efforts explain Magnet hospitals' higher satisfaction.

Methods: This cross-sectional study analyzed 2023 secondary data from 4 sources: the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), the Healthcare Equality Index (HEI), the American Hospital Association Annual Survey, and the list of Magnet-recognized organizations.

Minimum nurse staffing policy intervention in Queensland Australia improved nurse wellbeing and patient safety: A quasi-experimental intervention study.

Background: Nurse retention and wellbeing have reached alarmingly low levels in recent years and health systems globally are searching for large-scale systemic solutions to reduce nurse burnout, improve wellbeing, and increase job satisfaction and retention while simultaneously enhancing patient care quality and safety.

Objective: To evaluate whether a minimum nurse staffing policy intervention in Queensland Australia improved nurse wellbeing, intentions to leave employment, and patient safety.

Methods: This is a quasi-experimental intervention study in which we compared nurse outcomes, patient safety measures, quality of care indicators, and operational failures among 27 hospitals subject to a minimum nurse staffing policy (i.

The Influence of Pathway to Excellence® Designation on Patient Satisfaction.

Objective: This study investigated the association of Pathway to Excellence® (Pathway) status with patient satisfaction.

Background: The Pathway program recognizes hospitals committed to fostering optimal practice environments, yet research on its impact on patient satisfaction is limited.

Methods: This cross-sectional study linked 3 datasets: the Hospital Consumer Assessment of Healthcare Providers and Systems, the American Nurses Credentialing Center® Pathway and Magnet® organizations, and the American Hospital Association Annual Survey.

Association of Nurse Work Environment, Staffing, and Skill Mix With Length of Stay for Patients With Intellectual and Developmental Disabilities.

Introduction: Complex care for individuals with intellectual and developmental disability (IDD) may translate into longer than needed hospital lengths of stay (LOS). Nurses are poised to influence the outcomes of patients with IDD. But ample evidence suggests that nurses' capacity to provide optimal care may depend on key organizational features such as having sufficient staff, supportive work environments, and sufficient mix of registered nurses, termed nursing resources.

Associations Between Nurse Staffing Levels and 30- and 60-Day Readmissions for Acute Care Patients With Intellectual and Developmental Disability.

The purpose of this study was to examine the association between hospital nurse staffing levels and 30- and 60-day readmissions among patients with intellectual and/or developmental disabilities (IDD). This cross-sectional correlational study utilized secondary data from 595 acute care, nonfederal hospitals in California, Florida, New Jersey, and Pennsylvania in 2016. Data were obtained from three sources: the American Hospital Association Annual Survey, the RN4CAST-US nurse survey, and state patient hospital discharge summaries.

Hospital Ownership Type Correlated With Investments in Nursing Services: Evidence From Illinois.

Background: The association between hospital ownership type and patient care quality has garnered increased public attention.

Objectives: To describe differences in investments in nursing services, care quality and safety, and nurse job outcomes among for-profit and not-for-profit hospitals in Illinois.

Research Design: Cross-sectional, descriptive case study of hospital nursing services, patient care quality and safety outcomes, and nurse job outcomes in 113 hospitals in Illinois in 2021.

Multilevel Examination of Hospital Participation in the Healthcare Equality Index (HEI): The Role of Geographic Location and State Health Care Policies.

The Healthcare Equality Index (HEI) evaluates compliance with LGBTQ+ (lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender diverse individuals) inclusion in U.S. health care facilities and is associated with greater patient satisfaction.

Are minimum nurse-to-patient staffing ratios needed in hospitals? An observational study in British Columbia, Canada.

Objective: To evaluate staffing conditions, patient outcomes, quality of care, patient safety and nurse job outcomes in British Columbia (BC), Canada hospitals.

Design: Cross-sectional study of 58 hospitals in BC with surveys of nurses and independent measures of patient outcomes.

Setting: 58 hospitals in BC.

System-Level Factors Contributing to Burnout and Professional Well-Being Among Transgender and Gender-Diverse Nurses.

Introduction: Transgender and gender-diverse (TGD) health care professionals face significant burnout, yet evidence on system-level factors such as workplace discrimination that contribute to this issue among TGD nurses is limited. Responding to the U.S.

Poor Patient Care Outcomes and Nurse Job Outcomes Associated With Unfavorable Intensive Care Unit and Emergency Department Nurse Work Environments: Implications for Critical Care Medicine.

Objectives: Efforts to improve critical care outcomes are traditionally focused on intensive care unit (ICU) work environments, despite the reality that nurses in emergency departments (EDs) also deliver critical care. EDs and ICUs in the same hospitals tend to be differently resourced and may have different work environments as assessed by nurses. The objective of this study was to assess similarities in ED and ICU nurse work environment evaluations and associations with patient care and nurse job outcomes.

Nurses' Perceptions of Their Practice Environment in Public Hospitals: A Repeated Cross-Sectional Study.

The study aims to investigate registered nurses' perceptions of their practice environment in public hospitals. A 12-month repeated cross-sectional study with quarterly surveys was conducted in 71 adult medical and surgical wards in four public hospitals in Hong Kong. The perceptions of nurses' practice environment were measured by the 31-item Practice Environment Scale of the Nursing Work Index administered in four quarterly survey waves (ranging from 604 to 865 participants).

Association of emergency department nurse and physician work environment agreement on clinician job and patient outcomes.

Background: Emergency medicine is a highly interdisciplinary field, and emergency nurses and physicians have high rates of burnout compared to other specialties. National and international agencies prioritize investments in systems-based solutions to improve clinicians' work environments. The objective of this study was to determine whether emergency department (ED) clinicians agree on the quality of work environments, and whether their agreement is associated with job outcomes, patient safety, and quality of care.

Inclusive Hospital Policies, Nurse Burnout, and Job Turnover.

Background: Organizational turnover among nurses is associated with high levels of burnout, which may be exacerbated by workplace discrimination and exclusionary organizational policies. The theory of inclusive organizations suggests that fostering inclusive workplace environments can positively affect job retention.

Objectives: This study examined the role of inclusive hospital policies in shaping nurses' intentions to leave employment.

LGBTQ+ Inclusive Policies, Nurse Job Outcomes, and Quality of Care in Hospitals.

Importance: Despite emphasis on the establishment of inclusive hospital policies, the impact of these policies on employees and organizations remains unknown.

Objective: To evaluate the association between inclusive policies for lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender minority (LGBTQ+) and nurse job outcomes as well as nurse-reported quality of care.

Design, Setting, And Participants: This cross-sectional study analyzed 4 survey datasets from 2021: the RN4CAST-NY/IL, including registered nurses from New York and Illinois, and the Healthcare Equality Index (HEI) data.

Hospital Performance, Nursing Resources, and Health Inequities During the COVID-19 Pandemic.

Background: Few researchers have examined the organizational features of high-performing and low-performing hospitals for COVID-19 mortality during the pandemic, and how differences in hospital performance contributed to mortality disparities among socially vulnerable patients hospitalized with COVID-19.

Objectives: Our objectives were (a) to identify high- and low-performing hospitals on COVID-19 inpatient mortality and describe their distinguishing organizational characteristics, including nursing resources, and (b) to assess whether patients admitted to high-performing hospitals differed by social vulnerability level.

Methods: This analysis used linked nurse survey, hospital, and claims data for 73,792 hospitalized older adults diagnosed with COVID-19 across 96 New York and Illinois hospitals between January 1, 2020, and December 31, 2020.

Nurse Work Environment and Hospital Readmission Disparities Between Patients With and Without Limited English Proficiency.

Minimal progress has been made in narrowing disparities between patients with and without limited English proficiency (LEP). Using 2016 data from RN4CAST-US, New Jersey Discharge Data Collection System, and AHA Annual Hospital Survey, multivariable logistic regression models were employed to examine whether and to what extent the hospital nurse work environment, defined as the conditions that nurses work in, is associated with decreased disparities in 7-day hospital readmissions between patients with and without LEP. Existing literature has established associations between nurse work environments and outcomes disparities of various minoritized populations; however, no literature has examined this relationship in the context of hospitalized patients with LEP.

Lower Burnout Among Hospital Nurses in California Attributed to Better Nurse Staffing Ratios.

Hospital nurses report that improving patient-to-nurse staffing ratios is a priority intervention to improve their well-being. In 2004, California became the first state to implement a hospital-wide policy mandating safe staffing ratios. This cross-sectional study determined whether nurses in California hospitals exposed to a staffing policy ("California advantage") experienced lower nurse burnout compared to those in hospitals not exposed, and whether part of the differences in burnout can be attributed to better hospital staffing.

Impact of hospitals' LGBTQ+ inclusion efforts on patient satisfaction from 2016 to 2023: a retrospective longitudinal observational study.

Background: Given the emphasis on promoting inclusive policies, we investigated the relationship between US hospitals' inclusion efforts for lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender-diverse (LGBTQ+) populations and patient satisfaction from 2016 to 2023.

Methods: This retrospective longitudinal observational study analysed 6 years of data between 2016 and 2023 from the Healthcare Equality Index (HEI), which measures hospitals' LGBTQ+ inclusion efforts, and the Hospital Consumer Assessment of Healthcare Providers and Systems, which measures patient satisfaction. Generalised estimating equations (GEE) were used to obtain population-averaged estimates of the association between hospitals' LGBTQ+ inclusion efforts-assessed by (1) their participation and (2) performance in the HEI (range: 0-100)-and patient satisfaction-measured by (1) patients' hospital rating (range: 0-100) and (2) willingness to recommend the hospital (range: 0-100).

Association of Racial and Ethnic Composition with Staff Levels in Nursing Homes: 2013-2019.

Objectives: The nursing home (NH) population has become increasingly diverse, yet many facilities remain de facto racially segregated. This study examines whether a high proportion of Black, Indigenous, and People of Color (BIPOC) residents is associated with nursing staff levels.

Design: We constructed a longitudinal cohort of NHs (2013-2019) by linking Certification and Survey Provider Enhanced Reports, LTCFocUS.

Associations between nurse-to-patient ratio, nurse educational level, and nurse-sensitive patient outcomes: A 12-month prospective observational study.

Aim: To investigate the associations between nurse staffing levels, nurse educational level, and nurse-sensitive patient outcomes among patients in medical and surgical wards.

Background: Patient outcomes are affected by a variety of factors, including nurse staffing and registered nurse (RN) educational levels. An examination of the associations between these factors and patient outcomes will help identify the impact that nurses make on patient care, including health and safety.

Changes in Patient Care Experiences and the Nurse Work Environment: A Longitudinal Study of U.S. Hospitals.

Addressing patient experience is a priority in the health care system. Hospital Consumer Assessment of Providers and Systems (HCAHPS) survey results incentivize hospitals to elevate patient experience, a factor in patient-centered care. Although hospital nursing resources have been positively associated with better HCAHPS ratings, it is unknown how changes in nursing resources are associated with changes in HCAHPS ratings over time.

Hospital nurse staffing variation and Covid-19 deaths: A cross-sectional study.

Background: During the Covid-19 pandemic, Covid-19 mortality varied depending on the hospital where patients were admitted, but it is unknown what aspects of hospitals were important for mitigating preventable deaths.

Objective: To determine whether hospital differences in pre-pandemic and during pandemic nursing resources-average patient-to-registered nurse (RN) staffing ratios, proportion of bachelor-qualified RNs, nurse work environments, Magnet recognition-explain differences in risk-adjusted Covid-19 mortality; and to estimate how many deaths may have been prevented if nurses were better resourced prior to and during the pandemic.

Methods: This is a cross-sectional study of 87,936 Medicare beneficiaries (65-99 years old) hospitalized with Covid-19 and discharged (or died) between April 1 and December 31, 2020, in 237 general acute care hospitals in New York and Illinois.

Alternative Models of Nurse Staffing May Be Dangerous in High-Stakes Hospital Care.

Background: Hospitals are resurrecting the outdated "team nursing" model of staffing that substitutes lower-wage staff for registered nurses (RNs).

Objectives: To evaluate whether reducing the proportion of RNs to total nursing staff in hospitals is in the best interest of patients, hospitals, and payers.

Research Design: Cross-sectional, retrospective.

Validation of a short form of the practice environment scale of the nursing work index: The PES-5.

The Practice Environment Scale of the Nursing Work Index (PES-NWI) has been utilized for two decades globally to measure nurse work environments. Its 31 items in five domains present a substantial respondent burden, threatening survey response rates. The purpose of this study was to derive and validate a short form: the PES-5.