Examination Date

2022

Degree

Dissertation

Degree Program

Nursing (PhD)

Examination Committee

Demetrius Porche, Donald Mercante, Todd Tartavoulle, Marie Adorno, Benita Chatman, Shin Hye Park

Abstract

Objectives: The purpose of this study was to investigate the association of the nurse practice

environment and nurse staffing on pediatric acute care outcomes: FALLS, HAPI, CLABSI,

CAUTI, and VAP. The hypothesis was that nurse practice environment would have a greater

association on improved pediatric acute care outcomes through lower outcome rates.

Participants: A total of 216 pediatric units from 94 hospitals were included in the study.

Individual units were placed into groups for analysis: critical care (n=33, 15.3%), acute care (n =

89, 41.2%), neonatal (n = 75, 34.7%), and mixed (n = 19, 8.9%). Study Method: Secondary data

analysis of cross-sectional data was used for 2019 calendar year of the National Database of

Nursing Quality Indicators (NDNQI). Purposive sampling was used for pediatric units that

participated in NDNQI submitted data and utilized the PES-NWI. The NDNQI provides a

national repository which allows hospitals to confidentially compare nursing sensitive indicators

at the unit level to similar units across the country. Findings: Significant associations were

decreased Falls with RN Staffing (B = -.201, p = .012) in the acute care group, Collegial Nurse-

Physician Relations (B = -4.317, p = <.001) in the neonatal group, Collegial Nurse-Physician

Relations (B = -1.674 p = .028) in the pediatric units; decreased HAPI with Total Staffing

Categories (B = -1.038, p = .003) and RN Staffing Categories (B = -1.018, p = .003).

Conclusions: This study provides broader understanding of the association of the nurse practice

environment, nurse staffing, and pediatric acute care outcomes.

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