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We analyzed a longitudinal panel of 283 acute care hospitals in California from 1996 to 2001. Using an adaptation of the Quality Health Outcomes Model, we found no statistically significant relationships between RN staffing and the complications. In addition, the signs of the relationships were opposite to those expected. That is, as staffing increased, so did some of the complications. We discuss potential reasons for these anomalous results, including the possibility that increases in RN staffing may result in earlier detection of complications. Other explanations include issues with risk adjustment, the lack of nurse level variables in the model, and issues with the POA indicator itself. \u00a9 2009 Wiley Periodicals, Inc. Res Nurs Health 33:35\u201347, 2010<\/jats:p>","DOI":"10.1002\/nur.20361","type":"journal-article","created":{"date-parts":[[2009,12,14]],"date-time":"2009-12-14T15:17:36Z","timestamp":1260803856000},"page":"35-47","source":"Crossref","is-referenced-by-count":28,"title":["Nurse staffing and post\u2010surgical complications using the present on admission indicator"],"prefix":"10.1002","volume":"33","author":[{"given":"Barbara A.","family":"Mark","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W.","family":"Harless","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,12,14]]},"reference":[{"key":"e_1_2_1_2_1","volume-title":"Nurse staffing and patient outcomes in the inpatient hospital setting","author":"Author","year":"2000"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.2307\/2297968"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.00023"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31815f537f"},{"issue":"2","key":"e_1_2_1_6_1","first-page":"71","article-title":"Organizational determinants of nurse staffing patterns","volume":"6","author":"Becker E.","year":"1988","journal-title":"Nursing Economics"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/298348"},{"key":"e_1_2_1_8_1","volume-title":"The design and analysis of cohort studies","author":"Breslow N.E.","year":"1987"},{"key":"e_1_2_1_9_1","unstructured":"Buckley E.F. 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