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Table 3 Odds Ratios from random effects models indicating the effects of depression, the practice environment, nurse staffing and nurse education on the odds of 30-day mortality

From: Hospital nursing factors associated with decreased odds of mortality in older adult medicare surgical patients with depression

 

Unadjusted Model

Adjusted Model (1)

Adjusted Model (2)

Adjusted Model (3)

OR(CI)

P

Adjusted for patient/hospital characteristics OR (CI)

P

Adjusted for patient/hospital characteristics with Unconstrained Interaction OR (CI)

P

Adjusted for patient/hospital characteristics with Constrained Interaction OR (CI)

P

Depression

1.02 (0.97–1.08)

0.385

0.96 (0.90–1.01)

0.104

0.95 (0.90–1.00)

0.083

0.95 (0.90–1.00)

0.085

PES-NWI

0.92 (0.88–0.96)

 < 0.001

0.95 (0.91–0.99)

0.008

0.95 (0.91–0.99)

0.008

0.95 (0.91–0.99)

0.01

BSN10

0.96 (0.94–0.99)

0.002

0.96 (0.93–0.98)

 < 0.001

0.96 (0.93–0.98)

 < 0.001

0.96 (0.93–0.98)

 < 0.001

Staffing

0.99 (0.97–1.02)

0.608

1.00 (0.97–1.02)

0.753

0.99 (0.96–1.02)

0.420

***

 

Interaction Staffing x Depression

    

1.05 (1.01–1.09)

0.034

1.04 (1.01–1.08)

0.047

  1. Notes: Depression is indicated by the presence of a Chronic Condition Warehouse (CCW) depression flag. The PES-NWI is the Practice Environment Scale of the Nurse Work Index (excludes the Staffing and Resource Adequacy Subscale), measured in 1 standard deviation unit increments. Staffing is the ratio of patients to nurses and is a continuous measure. Education is the proportion of BSNs at the hospital level, measured in 10% increments. Patient characteristics include: age, sex, race, transfer status, procedure type (DRG), and Elixhauser comorbidities. Elixhauser comorbidities included: Congestive heart failure, cardiac arrhythmia, valvular disease, peripheral vascular disorders, pulmonary circulation disorders, hypertension complicated/uncomplicated, paralysis, other neurological disorders, chronic pulmonary disease, diabetes complicated/uncomplicated, hypothyroidism, renal failure, liver disease, peptic ulcer disease excluding bleeding, AIDS, lymphoma, metastatic cancer, solid tumor without metastasis, rheumatoid arthritis/collagen vascular disease, coagulopathy, obesity, weight loss, fluid and electrolyte disorders, blood loss anemia, deficiency anemias, alcohol abuse, drug abuse, psychoses (depression-excluded in this analysis). Hospital characteristics include: teaching status, technology status, size, location (CBSA), ownership, state, proportion of medical surgical and proportion of ICU nurses at the hospital level. Unadjusted models include the PES-NWI, staffing, and education only. Jointly adjusted models jointly adjust for the PES-NWI, staffing, and education and patient and hospital characteristics. Jointly adjusted models with the interaction jointly adjust for the PES-NWI, staffing, and education and patient and hospital characteristics in addition to the interaction between staffing and depression. OR: Odds Ratio; CI: Confidence Interval [27]