PMID- 19327286
OWN - NLM
STAT- MEDLINE
DCOM- 20091203
LR  - 20090811
IS  - 1557-8615 (Electronic)
IS  - 0883-9441 (Linking)
VI  - 24
IP  - 3
DP  - 2009 Sep
TI  - The costs and savings associated with prevention of adverse events by critical 
      care nurses.
PG  - 471.e1-7
LID - 10.1016/j.jcrc.2007.12.021 [doi]
AB  - PURPOSE: The aim of the study was to determine the costs and savings associated 
      with prevention of adverse events (AEs) by critical care nurses. MATERIALS AND 
      METHODS: We performed a secondary analysis of data from 2 coronary care unit 
      (CCU) studies that determined the incremental cost of AEs and the rate of near 
      misses recovered by nurses during weekday, daytime shifts. For this study, we 
      determined the nurse staffing costs and savings by averting AEs. Physicians 
      judged the likelihood that observed near misses would have resulted in actual AEs 
      if not initially intercepted. A sensitivity analysis was performed on the savings 
      from preventing AEs and the costs of different nurse staffing ratios and 
      experience levels. RESULTS: We observed 66 recovered near misses during 308 
      observation hours, with 34 (51.5%) judged to likely have reached and harmed the 
      patient resulting in an AE if not intercepted. The annual incidence of prevented 
      AEs extrapolated to 2296 events. Savings from prevented AEs ranged from $2.2 
      million to $13.2 million. Nurse staffing costs for the same time frame was $1.36 
      million. CONCLUSIONS: Although CCU nursing staffing costs are significant, the 
      potential savings associated with preventing AEs is far greater. Further research 
      is needed to identify the optimal nurse staffing ratios.
FAU - Rothschild, Jeffrey M
AU  - Rothschild JM
AD  - Division of General Medicine and Primary Care, Department of Medicine, Brigham 
      and Women's Hospital, Boston, MA 02120-1613, USA. jrothschild@partners.org
FAU - Bates, David W
AU  - Bates DW
FAU - Franz, Calvin
AU  - Franz C
FAU - Soukup, Jane R
AU  - Soukup JR
FAU - Kaushal, Rainu
AU  - Kaushal R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20080418
PL  - United States
TA  - J Crit Care
JT  - Journal of critical care
JID - 8610642
SB  - IM
MH  - Coronary Care Units/*economics/organization & administration
MH  - Costs and Cost Analysis
MH  - Humans
MH  - Medical Errors/*prevention & control
MH  - Nursing Administration Research
MH  - Nursing Staff, Hospital/*economics/organization & administration
MH  - Personnel Staffing and Scheduling/organization & administration
EDAT- 2009/03/31 09:00
MHDA- 2009/12/16 06:00
CRDT- 2009/03/31 09:00
PHST- 2007/10/08 00:00 [received]
PHST- 2007/12/15 00:00 [accepted]
PHST- 2009/03/31 09:00 [entrez]
PHST- 2009/03/31 09:00 [pubmed]
PHST- 2009/12/16 06:00 [medline]
AID - S0883-9441(08)00027-0 [pii]
AID - 10.1016/j.jcrc.2007.12.021 [doi]
PST - ppublish
SO  - J Crit Care. 2009 Sep;24(3):471.e1-7. doi: 10.1016/j.jcrc.2007.12.021. Epub 2008 
      Apr 18.