Medical care
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Comparative Study
The effect of staff nursing on length of stay and mortality.
Specialized hospital units developed historically for the efficiency of physicians, but their existence has created an opportunity for staff nurses to specialize as well. This study was done to test the hypothesis that specialized staff nursing has an effect on patient outcome as length of stay (LOS) and mortality, using casemix information and controlling for physician volume. ⋯ The notion that nurses improve at caring for similar patients of a stable group of physicians as their experience increases has common sense appeal. If the findings of this study can be replicated in other institutions, with the refinements suggested here, it may be possible to separate the effects of multidisciplinary practice on outcomes and to track the effect of hospital reengineering projects that change patient mix or nursing specialization. Studying one hospital in depth suggested that interhospital studies of cost and quality may need to consider nursing specialization along with other comparisons.