Multivariate multilevel regression analysis of process/structure measures and nurses’ self-reported work-related and patient-related outcomes (N=3618)
| Work-related outcomes | Patient-related outcomes | |||
|---|---|---|---|---|
| Quality of nursing | Patient safety | Self-care ability | Low frequency AE | |
| Coefficient (p value) | ||||
| Process measures | ||||
| Patient safety management | 0.09 (<0.001) | 0.19 (<0.001) | 0.13 (<0.001) | 0.06 (<0.001) |
| Staff adequacy | 0.12 (<0.001) | 0.12 (<0.001) | 0.10 (<0.001) | 0.04 (<0.001) |
| Nurse–physician relation | 0.06 (0.003) | 0.07 (<0.001) | 0.08 (0.006) | |
| Education and career | ||||
| Quality system | 0.25 (<0.001) | 0.18 (<0.001) | 0.21 (<0.001) | 0.09 (<0.001) |
| Nurse participation | −0.04 (0.028) | |||
| Ward leadership | 0.05 (0.011) | −0.03 (0.008) | ||
| Structure measures | ||||
| Local university hospital | −3.08 (0.008) | |||
| Regional university hospital | 3.57 (0.003) | 1.89 (0.024) | 1.48 (0.375) | |
| Nurse–patient ratio-R | 0.21 (0.127) | |||
| Physician–patient ratio-R | −0.28 (0.290) | |||
| Bed occupancy-R | 0.00 (0.955) | −0.25 (0.055) | −0.09 (0.127) | |
| Index for patient mix-R | 0.01 (0.861) | 0.10 (0.415) | ||
| Nurse experience-R | −0.77(0.071) | 0.33 (0.051) | ||
| Hospital size-R | −0.02 (0.533) | |||
| Medical department | 0.23 (0.769) | −1.12 (0.039) | −5.89 (<0.001) | |
| Interactions | ||||
| Index for patient mix-R × Medical department | 0.14 (0.114) | −0.28 (0.032) | ||
| Nurse–patient ratio-R × nurse experience-R | 0.16 (0.013) | |||
| Physician–patient ratio-R × nurse experience-R | −0.28 (0.066) | |||
| Bed occupancy-R × Medical department | −0.10 (0.227) | |||
| Intra class correlation | ||||
| ICC(%)/design effect (hospital ward level) | 5.68/1.69 | 2.46/1.30 | 5.35/1.65 | 8.64/2.05 |
| ICC(%)/design effect (hospital level) | 0.56/1.47 | 0,72/1.61 | 0.22/1.19 | 0.74/1.62 |