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The effect of nurse manager turnover on patient fall and pressure ulcer rates
Author(s) -
Warshawsky Nora,
Rayens Mary Kay,
Stefaniak Karen,
Rahman Rana
Publication year - 2013
Publication title -
journal of nursing management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.925
H-Index - 76
eISSN - 1365-2834
pISSN - 0966-0429
DOI - 10.1111/jonm.12101
Subject(s) - medicine , odds ratio , nursing management , nursing , confidence interval , intensive care unit , nurse manager , turnover , interim , nursing care , intensive care medicine , management , archaeology , economics , history
Aims The purpose of this study was to explore the effects of nurse manager turnover on the occurrence of adverse events. Background Nurse managers create professional nurse practice environments to support the provision of quality patient outcomes. Inconsistent findings were reported in the literature testing the relationship between nurse managers and patient outcomes. All prior studies assumed stable nursing management. Methods A longitudinal quasi‐experimental study of 23 nursing units in two hospitals was used to determine whether unit characteristics, including nurse manager turnover, have an effect on patient falls or pressure ulcers. Statistical analyses included repeated measures and hierarchical modelling. Results Patients in medical/surgical units experienced more falls than in intensive care units ( F 1,11 = 15.9, P = 0.002). Patients in units with a nurse manager turnover [odds ratio: 3.16; 95% confidence interval: 1.49–6.70] and intensive care units (odds ratio: 2.70; 95% confidence interval: 1.33–5.49) were more likely to develop pressure ulcers. Conclusions Nurse manager turnover and intensive care unit status were associated with more pressure ulcers. Medical/surgical unit status was associated with more falls. The study was limited by a small sample size. Implications for nurse managers Nurse manager turnover may negatively impact patient outcomes. Stable nursing management, strategic interim management and long‐term succession planning may reduce adverse patient events.