Association of registered nurse and nursing support staffing with inpatient hospital mortality.

Background: The association of nursing staffing with patient outcomes has primarily been studied by comparing high to low staffed hospitals, raising concern other factors may account for observed differences. We examine the association of inpatient mortality with patients' cumulative exposure to shifts with low registered nurse (RN) staffing, low nursing support staffing and high patient turnover.

Methods: Cumulative counts of exposure to shifts with low staffing and high patient turnover were used as time-varying covariates in survival analysis of data from a three-campus US academic medical centre for 2007-2012.

Assessment of Activity of Daily Living Among Older Adult Patients in Home Healthcare and Skilled Nursing Facilities: An Integrative Review.

Older adult's ability to self-manage illness is dependent on their ability to perform activities of daily living (ADL). Forty-five percent of those older than 65 years will have ongoing clinical needs after hospital discharge and require postacute care (PAC) services in settings such as home healthcare (HHC) and skilled nursing facilities (SNF). The Improving Medicare Post-Acute Care Transformation Act of 2014 requires PAC providers to begin collecting and reporting ADL data to build a coordinated approach to payment and standardize patient assessments and quality measurement.