Grant: CIHR New Investigator

Adverse events (AEs) occur in 2.9% to 16.6% of all acute care hospitalizations and are responsible for 44,000 to 98,000 deaths each year. Moreover, it is estimated that 30% to 58% of all AEs are preventable. Recent studies suggest that understaffing and certain nurse staffing policies, such as the use of less qualified nursing staff and of overtime hours to meet peak staffing demands, could significantly contribute to the occurrence of preventable AEs. However, there is scant evidence-based information to guide nursing managers in defining the optimal numbers and mixes of nursing staff that are required to minimize the risk of AE. To meet this need, longitudinal studies are required to systematically examine the relationship between various nurse staffing policies and the occurrence of AEs, as well as to define safe staffing policies. Until recently, the detailed data required to conduct such an investigation were not easily accessible. With the advent of electronic health records and the digital capture of nurse staffing data, there is now an exciting opportunity to optimize the management of nursing resources in acute care hospitals. The goal of this program of research is to determine if: a) nurse staffing policies are associated with an increased risk of AEs, b) the risk of AEs in relationship to nurse staffing policies is modified by the complexity of patient requirements and, c) optimal nurse staffing thresholds can be established by level of patient complexity. An important prerequisite to answer these important questions in the management of nursing staff in acute care hospitals is to have access to accurate measures of AE occurrence. For this reason, a fourth objective of this program of research is to pursue the development and the validation of such measures.