To determine whether and to what extent the lower mortality rates for patients undergoing abdominal aortic aneurysm () repair in high‐volume hospitals is explained by better nursing.
State hospital discharge data, ulti‐tate ursing are and atient afety urvey, and hospital characteristics from the nnual urvey.
Cross‐sectional analysis of linked patient outcomes for individuals undergoing repair in four states.
Secondary data sources.
Favorable nursing practice environments and higher hospital volumes of repair are associated with lower mortality and fewer failures‐to‐rescue in main‐effects models. Furthermore, nurse staffing interacts with volume such that there is no mortality advantage observed in high‐volume hospitals with poor nurse staffing. When hospitals have good nurse staffing, patients in low‐volume hospitals are 3.4 times as likely to die and 2.6 times as likely to die from complications as patients in high‐volume hospitals ( < .001).
Nursing is part of the explanation for lower mortality after repair in high‐volume hospitals. Importantly, lower mortality is not found in high‐volume hospitals if nurse staffing is poor.