Nursing unit characteristics and patient outcomes

The author explored the extent to which the relationship between organizational characteristics and outcomes exist at the unit level. Using the Nursing Work Index Revised - B (NWI-R (B)) instrument, characteristics such as practice control, nurse-physician collaboration, nurse management support, and continuity/specialization were evaluated in comparison to the occurrence of nursing-sensitive adverse events such as falls, UTIs, pressure ulcers, and failure to rescue. Higher degrees of nurse-perceived a utonomy/collaboration were associated with better outcomes for patients experiencing adverse events (failure to rescue) and UTIs. When continuity/specialization was perceived as high, pneumonia, cardiac arrest, and LOS were low. High levels of nurse manager support were associated with low levels of pressure ulcer prevalence and death, yet higher rates of failure to rescue. Interestingly, practice control and nurse manager support were not correlated with adverse events with any significance.