Restructuring of nursing care models has led to more ''nonprofessional
'' caregivers, sometimes called unlicensed assistive personnel (UAPs)
who provide more of the basic delegable direct patient care activities
in collaboration with RNs. The purpose of this study, wherein data we
re collected from 39 units in 11 hospitals, was to determine the relat
ionship between different levels of nurse staffing and patient outcome
s (adverse occurrences). Using and tracking the same indicators of pat
ient quality outcomes over a significant time period in different inst
itutions with similar patient groups would greatly enhance the usefuln
ess of such data. Among the more surprising findings in this study was
the ''non-linear'' relationship between the proportion of RNs in the
staff mix and MAEs. As the proportion of RNs on a unit increased from
50% to 85% ''the rate of MAEs declined, but as the RN proportion incre
ased from 85% to 100% the rate of MAEs increased.'' Further investigat
ions are needed to explain this finding.