Comparing an All-RN Unit to a Mixed-Skill Unit at a Hospital.

Dzikowicz, Dillon J; Schmitt, Linda A; Gastle, Karen; Skermont, Amanda; Carey, Mary G

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.