Exploring the relationship between nursing hours per patient day and mortality rate of hospitalised patients in Taiwan

Aim To investigate the relationship between nursing hours per patient day and the inpatient mortality rate in Taiwan. Background Nursing hours per patient day has been associated with better patient outcomes. The literature is inconclusive on the relationship between nursing hours per patient day and the inpatient mortality rate, and no studies have yet examined this issue in Taiwan. Methods A retrospective longitudinal study analysed data from the ‘Nursing Utilization of Resources, Staffing and Environment on Outcome Study: NURSE-outcome study’. Hierarchical regression estimated the relationship between nursing hours per patient day and in-hospital mortality rate after controlling for confounding variables. Results The mean nursing hours per patient day in Taiwan was 2.3, while the mean inpatient mortality rate was 0.73% higher nursing hours per patient day was associated with a lower inpatient mortality rate after controlling for confounding variables. The total explained variance of this study in inpatient mortality rate was 19.9%. Significant relationships to inpatient mortality were found in levels of hospitals, seasonal variation and nurses’ work experience. Conclusion Nursing hours per patient day affects the mortality rate among hospitalised patients in Taiwan. Implications for nursing management According to the results, we suggested the government and managers in Taiwan double the nursing hours per patient day so that the inpatient mortality rate will decline by 1.1%. This might be the optimal nurse configuration that could provide a balance between cost-effectiveness and patient safety.