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Comparing an All-RN Unit to a Mixed-Skill Unit at a Hospital
Dillon J Dzikowicz1, Linda A Schmitt, Karen Gastle
1Author Affiliations: Doctoral (PhD) Candidate, School of Nursing, and Registered Nurse (Mr Dzikowicz); Nurse Manager and Nurse Retention Officer (Ms Schmitt); Advanced Practice Registered Nurse & Nurse Educator (Ms Gastle); Nurse Manager (Ms Skermont); and Associate Professor and Director of Clinical Nursing Research Center (Dr Carey), University of Rochester Medical Center, New York.
Objective:
The aim of this study was to assess the differences in patient complications as well as patient and staff satisfaction between a mixed-skill unit and an all-registered nurse (RN) unit.
Background:
It is recognized that nursing care delivered by RNs results in better outcomes; however, more evidence is needed to support a change to an all-RN unit.
Methods:
A mixed unit with RNs and unlicensed assistive personnel was compared with an all-RN unit. Each unit had similar resources. Patient complications and patient and staff satisfaction were measured. Patient complications were reported in terms of 1,000 patient days over the study period to minimize noise fluctuations; t test and χ compared means and frequencies, respectively.
Results:
The all-RN unit had a lower prevalence of patient complications. Patients reported better pain management, and nurse explanation, and reported higher satisfaction on the all-RN unit.
Conclusions:
An all-RN unit provided superior outcomes compared with a mixed-skill unit without additional costs.
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