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Over the last several years, nurses and their advocates have expressed concern about heavy use of overtime in hospitals and claimed that it undermines the quality of nursing care. However some hospital managers view overtime as an important staffing and scheduling tool. This book examines trends in the use of nurse overtime and its effects on several nurse-sensitive patient outcomes. Previous studies have demonstrated a relationship between several patient outcomes and nurse staffing levels, but little is known about the impact of nurse overtime on patient outcomes. Using staffing and discharge data covering 1995 to 2000 from 160 acute general hospitals in New York State, this book examines hospital characteristics that are associated with the use of overtime and examines trends in the use of overtime. Finally, it uses multivariate regression to analyze the relationship between overtime and the rates of six nurse-sensitive patient outcomes and mortality. This analysis should be useful to managers making decisions among overtime, use of agency staff, and increased base staffing as well as to researchers concerned with health care quality and staffing.

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Barbara Berney, PhD, MPH is an Associate Professor in Urban Public Health at Hunter College, New York.

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