Evaluation of a Patient Care Delivery Model: Patient Outcomes in Acute Cardiac Care

Purpose: To evaluate the influence of nurse staffing and work environment variables on patient outcomes by testing a conceptual model. Design: A prospective, correlational design with cross-sectional and longitudinal components was conducted in Canadian cardiac and cardiovascular care inpatient units. Methods: Data were collected from multiple sources. Hierarchical linear modeling was used to examine relationships among variables. Conclusions: The findings indicate that patient outcomes are influenced not only by patient and nurse characteristics, but also by organizational staffing practices. Organizations that manage the complexity of work conditions and target staffing utilization levels between 80% and 88% at the unit level can optimize patient outcomes. Clinical Relevance: Empirical validation of the model provides evidence to inform management decisions about hospital nurse staffing.