Patient turnover and the relationship between nurse staffing and patient outcomes

Res Nurs Health. 2012 Jun;35(3):277-88. doi: 10.1002/nur.21474. Epub 2012 Mar 27.


High patient turnover (patient throughput generated by admissions, discharges, and transfers) contributes to increased demands and resources for care. We examined how the relationship between registered nurse (RN) staffing and failure-to-rescue (FTR) varied with patient turnover levels by analyzing quarterly data from the University HealthSystem Consortium. The data included 42 hospitals, representing 759 nursing units and about 1 million inpatients. Higher RN staffing was associated with lower FTR. When patient turnover increased from 48.6% to 60.7% on nonintensive units (non-ICUs), the beneficial effect of non-ICU RN staffing on FTR was reduced by 11.5%. RN staffing should be adjusted according to patient turnover because turnover increases patient care demand beyond that presented by patient count, and outcomes may be adversely affected.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diagnosis-Related Groups / statistics & numerical data
  • Hospitals / standards
  • Hospitals / statistics & numerical data
  • Humans
  • Intensive Care Units / standards
  • Intensive Care Units / statistics & numerical data
  • Length of Stay / statistics & numerical data*
  • Nursing Staff, Hospital / statistics & numerical data
  • Nursing Staff, Hospital / supply & distribution*
  • Outcome Assessment, Health Care / statistics & numerical data
  • Patients / statistics & numerical data*
  • Personnel Staffing and Scheduling / statistics & numerical data
  • Workforce