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The Association between Nursing Skill Mix and Patient Outcomes in a Mental Health Setting: An Observational Feasibility Study

Author

Listed:
  • Nompilo Moyo

    (School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
    Victorian Tuberculosis Program, Melbourne Health, Melbourne, VIC 3000, Australia)

  • Martin Jones

    (School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
    Department of Rural Health, University of South Australia, Whyalla Norrie, SA 5608, Australia
    IIMPACT in Health, University of South Australia, Adelaide, SA 5000, Australia)

  • Shaun Dennis

    (Whyalla Integrated Mental Health Service, Flinders & Upper North Local Health Network, Whyalla, SA 5600, Australia)

  • Karan Sharma

    (Austin Health, Melbourne, VIC 3084, Australia)

  • Michael McKeown

    (Whyalla Integrated Mental Health Service, Flinders & Upper North Local Health Network, Whyalla, SA 5600, Australia)

  • Richard Gray

    (School of Nursing and Midwifery, La Trobe University, Melbourne, VIC 3086, Australia
    Department of Rural Health, University of South Australia, Whyalla Norrie, SA 5608, Australia)

Abstract

Higher levels of educational preparation for nurses are associated with lower mortality rates in both medical and surgical wards. In mental health inpatient wards, few studies have examined whether specialist mental health nurse training has any impact on patient outcomes. The aim of this retrospective observational study was to establish the feasibility of extracting and linking nurse education and inpatient outcome data from hospital administrative sources to inform the design of future mental health nursing skill mix studies. Study participants were people experiencing mental ill-health and admitted to psychiatric inpatient care for at least 24 h. The exposure was the ratio of mental health nurses to comprehensive nurses for each patient for each day of their admission. The outcome was readmission for psychiatric inpatient care within 12 months of discharge from the index admission. Confounders were patient demographic (age, gender) and clinical characteristics (diagnosis, legal status, community follow-up). Forty-four patients included in the study were inpatients for a total of 595 days. The median hospital stay was 12 days (IQR = 7–17). In total, 11 (25%) patients were readmitted. In the readmitted and not readmitted groups, the median skill mix ratio was 5 (IQR = 5–7) and 5 (1–6), respectively. It was feasible to extract and code patient and nurse data from hospital databases and link them together. However, a substantial amount of manual post hoc recoding was required to enable us to calculate the exposure (mental health to comprehensive nurse ratio) in a precise way. It may be realistic to automate our methodology in an appropriately powered mental health nursing skill mix study. Australian and New Zealand clinical trial registry: ACTRN12619001337167p.

Suggested Citation

  • Nompilo Moyo & Martin Jones & Shaun Dennis & Karan Sharma & Michael McKeown & Richard Gray, 2023. "The Association between Nursing Skill Mix and Patient Outcomes in a Mental Health Setting: An Observational Feasibility Study," IJERPH, MDPI, vol. 20(3), pages 1-11, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:3:p:2715-:d:1056393
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    References listed on IDEAS

    as
    1. Nompilo Moyo & Martin Jones & Shaun Dennis & Karan Sharma & Richard Gray, 2022. "The Association between Nursing Skill Mix and Patient Outcomes in a Mental Health Setting: Protocol for an Observational Feasibility Study," IJERPH, MDPI, vol. 19(7), pages 1-10, April.
    2. Lucas O. F. Sales & André L. S. Pinho & Marcelo Bourguignon & F. Moisés C. Medeiros, 2022. "Control charts for monitoring the median in non-negative asymmetric data," Statistical Methods & Applications, Springer;Società Italiana di Statistica, vol. 31(4), pages 1037-1068, October.
    3. Sujin Shin & Jin‐Hwa Park & Sung‐Heui Bae, 2019. "Nurse staffing and hospital‐acquired conditions: A systematic review," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(23-24), pages 4264-4275, December.
    4. Nompilo Moyo & Martin Jones & Diana Kushemererwa & Sandesh Pantha & Sue Gilbert & Lorena Romero & Richard Gray, 2020. "The Association between the Mental Health Nurse-to-Registered Nurse Ratio and Patient Outcomes in Psychiatric Inpatient Wards: A Systematic Review," IJERPH, MDPI, vol. 17(18), pages 1-12, September.
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