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Table 6 Characteristics of the reviews included for staffing models

From: Evidence from facility level inputs to improve quality of care for maternal and newborn health: interventions and findings

Reviews Description of included interventions Type of studies included (no) Targeted health care providers Outcome reported Pooled data (Y/N) Results
     Other outcomes MNCH specific outcomes   
Butler 2011[53] Interventions of staffing models, staffing levels, skill mix, grade mix, or qualification mix. RCT: 08
CCT: 02
Hospital nursing staff and hospital patients in HIC In-hospital mortality   Yes 0.96 (0.59-1.56)
     Length of stay    1.35 lower (1.92-0.78)
     Readmission    1.15 (0.88-1.52)
     ED within 30 days    1.14 (0.79-1.62)
     Post-discharge admission    1.33 (0.93-1.91)
     ED visit or death    1.03 (0.7 - 1.53)
     Post discharge adverse events
Glycosylated hemoglobin
   0.5 lower (1.9 lower – 0.9 higher)
      Medical procedures in labor   Reduced (1/1)
      Length of stay   Reduced (1/1)
Hodgekinsons 2011[65] Interventions of interest included organizational interventions
(e.g. team/modular nursing, primary nursing, hierarchical nursing, care pairs or partner-in-care models) or regulatory interventions
(e.g. staff patient/resident ratios).
ITS: 01
CBA: 01
Nurses and personal care attendants in HIC • Incidence of pressure ulcers;   No Two studies generally favour the use of primary care
     • Incidence of falls;    
     • Incidence of medication errors and adverse events;    
     • Validated quality of life measurements.    
     • Days/hours lost to sick leave;    
     • Days/hours lost to stress leave;    
     • Staff turnover rates (as a percentage of staff total);    
     • Staff burnout (as defined by the authors).    
Kane 2007[55] Nursing staffing models 7 case-control
3 case series
42 cross sectional
43 assessed temporality
Nurses in HIC In hospital related mortality by increasing 1 RN FTE/patient day   Yes 0.92 (0.90-0.94)
     Failure to rescue by increasing 1 RN FTE/patient day    0.91 (0.89; 0.94)
     Length of stay by increasing 1 RN FTE/patient day    -0.25 (0.02)
Kane 2007[54] Various authors had used different operational definitions for the RN-to-patient ratio, including number of patients cared for by 1 RN per shift and the number of RN FTEs per patient day, 1000 patient days, or occupied bed. 17 cohort,
7 cross sectional,
4 case control,
Nurses Per additional full time equivalent per patient day   Yes Per additional full time equivalent per patient day
     Hospital related mortality in ICUs    0.91 (0.86-0.96
     Surgical    0.84 (0.80-0.89)
     Medical patients    0.94 (0.94-0.95)
     An increase by 1 RN per patient day    An increase by 1 RN per patient day
     Hospital acquired Pneumonia    0.70 (0.56-0.88)
     Unplanned extubation    0.49 (0.36-0.67)
     Respiratory failure    0.40 (0.27-0.59)
     Cardiac arrest    0.72 (0.62-0.84)
     Risk of failure to rescue    0.84 (0.79-0.90)
     Length of stay was shorter by 24%    0.76 (0.62-0.94)
Thungjaroenkul 2007[56] Nursing staff 17 studies: 2 prospective, 10 retrospective, 4 retrospective and prospective study, 1 Pre-post quasi-experimental design Nurses in HIC Patient length of stay   No Sufficient numbers of RNs may prevent patient adverse events that cause patients to stay longer
     Hospital costs    
Zwarenstein 2009[52] A practice-based intervention introduced to a practice setting with an explicit objective of improving collaboration between two or more health and/or social care professionals. 5 RCT Health care professionals Health measures   No IPC interventions can improve healthcare processes and outcomes,
     Quality of life measures    
     Complication rates