Objective: The purpose of this study was to describe relationships amo
ng adverse patient occurrences aggregated at the unit level of measure
ment. Relationships between adverse occurrences and a patient acuity m
easure were also described. Background: Adverse patient occurrence dat
a have been traditionally a major indicator of quality care in hospita
ls; however, few studies have examined relationships among these indic
ators or the usefulness of these indicators for assessing the quality
of nursing care. Methods: A correlational design was used to examine a
nd describe patterns of relationships among inpatient units in a terti
ary care hospital. The results demonstrated positive correlations betw
een medication error rates and patient falls; these adverse occurrence
s correlated negatively with. pressure ulcers, infections, patient com
plaints, and death. Pressure ulcers, infections, patient complaints an
d death intercorrelated positively and also related positively to pati
ent acuity levels. Results: An examination of these same rates for a s
ubset of units with similar patient acuity levels revealed that most o
f the interrelationships among the entire set of adverse occurrence in
dicators were positive. When patient acuity was taken into account, th
ese adverse outcomes appeared to indicate some common underlying chara
cteristic of the units, such as quality of nursing care. Conclusions:
This study suggests a relationship between the adverse occurrences tha
t were correlated (pressure ulcers, patient complaints, infection, and
death) and the severity of patient illness. Medication error rates an
d patient fall rates were not correlated with patient acuity and are m
ore likely to indicate quality of nursing care across all types of uni
ts.