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Journal Article > Study
Stone PW, Mooney-Kane C, Larson EL, et al. Med Care. 2007;45:571-578.
This study examined the relationship between nurse staffing and hospital characteristics and specific patient safety measures, such as nosocomial infection rates and incidence of decubitus ulcers. Lower nurse-to-patient ratios and increased overtime both negatively impacted patient safety and in-hospital mortality, but hospital characteristics were not associated with safety measures. The study confirms and extends the findings of previous studies, which have demonstrated that lower nurse staffing and extended shifts are associated with self-reported errors and increased mortality.
Journal Article > Commentary
Sachs BP. JAMA. 2005;294:833-840.
Part of a series in JAMA entitled Clinical Crossroads, this case study discusses the unfortunate events surrounding a 38-year-old woman's presentation to a labor and delivery unit. The case details a seemingly routine full-term pregnancy that rapidly evolved into a course of complications, ultimately leading to a fetal death, a hysterectomy, and a prolonged hospital course. The discussion shares the experience through the eyes of the patient, her husband, and the primary obstetrician. Further exploration of the case identified several specific factors and broader systems issues that contributed to the events. The author shares how this particular institution responded with overarching changes, including a greater emphasis on teamwork, communication, and appropriate staffing of labor and delivery units to promote safety.