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Journal Article > Study
Law AC, Stevens JP, Hohmann S, Walkey AJ. Crit Care Med. 2018;46:1563-1569.
Inadequate nurse staffing in hospitals leads to increased morbidity and mortality. Two proposed explanations are that nurses provide surveillance and reassessment, which are particularly important for seriously ill patients, and that inadequate staffing leads to missed nursing care. This retrospective cohort study assessed the impact of a 2016 Massachusetts law that mandated minimum nursing ratios in intensive care units. Mortality and complication rates did not change after the law's passage, nor did they differ from states without staffing ratio mandates. Nurse staffing was not substantially higher in Massachusetts after the mandate when compared with other states. Two accompanying editorials highlight the challenges of measuring and promoting appropriate nursing care, which authors argue cannot be simply defined with a staffing ratio. A PSNet perspective and a WebM&M commentary further explore the safety risks of missed nursing care.
Journal Article > Study
Dixon-Woods M, Leslie M, Tarrant C, Bion J. Implement Sci. 2013;8:70.
The Matching Michigan program attempted to replicate the success of the Keystone ICU study at preventing central line–associated bloodstream infections in intensive care units (ICUs) in England. However, Matching Michigan was unsuccessful in that infection rates declined at similar rates in both intervention and control units. A counterpart to the landmark study exploring why the Keystone ICU study succeeded, this ethnographic analysis identified external factors (Matching Michigan was perceived as a regulatory, top-down initiative) and internal factors (participating hospitals had widely varying prior experiences with quality improvement projects) that influenced uptake and success of the project at the individual hospital level. Overall, only 1 of the 19 intervention ICUs studied truly transformed their practices and culture toward preventing hospital-acquired infections.
Journal Article > Commentary
Moreno RP, Rhodes A, Donchin Y. Intensive Care Med. 2009;35:1667-1672.
This statement outlines the evidence around patient safety improvement and professes the intent of the European Society of Intensive Care to lead a patient safety initiative throughout Europe.
Graham J. Chicago Tribune. August 21, 2007;Metro section:1.
This article discusses a new Illinois state law that requires hospitals to screen all intensive care patients for methicillin-resistant Staphylococcus aureus (MRSA) infections and to isolate infected patients.