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Case control study
Higher levels of nurse staffing are not associated with reduced adverse events among postoperative children if surveillance levels are low
  1. Eileen Lake
  1. School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to : Dr Eileen Lake, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104, USA; elake{at}

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Implications for practice and research

  • The level of nurse staffing influences the priority nurses give to surveillance; nursing units should be adequately staffed to support the surveillance of all patients.

  • Managers should routinely check with staff nurses to learn which patients they are monitoring most frequently.

  • Nurses caring for postoperative patients should give extra attention to patients with comorbidities.

  • Nursing systems research should focus on the pathways through which nursing system features influence care processes and patient outcomes.


Over the past decade, considerable evidence from cross-sectional studies has established that patient outcomes are better in hospitals with better nursing features, with staffing being the dominant feature studied.1 Other prominent …

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  • Competing interests None.