{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:56:10Z","timestamp":1782608170303,"version":"3.54.5"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003030","name":"Ag\u00e8ncia de Gesti\u00f3 d'Ajuts Universitaris i de Recerca","doi-asserted-by":"publisher","award":["2021SGR00929"],"award-info":[{"award-number":["2021SGR00929"]}],"id":[{"id":"10.13039\/501100003030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adverse events (AEs) are linked to nurse staffing levels and care complexity factors; however, evidence in patients hospitalized for cardiac conditions is limited. The acute to intensive care (ATIC) patient classification system measures patient acuity according to required nurse hours per patient day (NHPPD), thereby enabling calculation of nurse staffing coverage. A prior study defined safe nurse staffing coverage as achieving \u226590% of the required NHPPD with the available nurse staffing. The aim of this study was to examine the associations between safe nurse staffing coverage and care complexity factors and AEs in patients hospitalized for cardiac conditions in three high-complexity hospitals in Catalonia between January and December 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a cross-sectional multicenter study that included patients admitted for cardiological reasons at three high-complexity hospitals of the Catalan Institute of Health in Catalonia between January and December 2022. Data regarding care complexity individual factors and patient acuity, according to the ATIC patient classification system, were obtained from electronic health records. The main outcomes were nursing-sensitive AEs that included falls, pressure ulcers, phlebitis, cardiorespiratory arrest, acute pulmonary edema (APE), and aspiration pneumonia. Safe nurse staffing coverage was defined as achieving \u226590% of the required NHPPD. Other clinical and sociodemographic variables were also collected. A descriptive and comparative analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 6,873 patients included in the study, 11.4% experienced one of the AEs studied, the most common being APE, present in 5% of cases. The mean nurse staffing coverage was 64.3%. Patients admitted to step-down units and those admitted for surgical reasons received the highest nurse staffing coverage, at 97.7% and 65.7%, respectively. The risk factors independently associated with AEs were old age, consciousness disorders, chronic disease, hemodynamic instability, and transmissible infection. Safe nurse staffing coverage was a protective factor against AEs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Older age, consciousness disorders, chronic disease, hemodynamic instability, and transmissible infection were independently associated with nursing-sensitive AEs, while safe nurse staffing coverage was a protective factor. These findings should inform staffing decisions and shape future healthcare-management policies aimed at improving health outcomes among adults hospitalized in cardiology wards.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1810207","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T04:46:20Z","timestamp":1781239580000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Associations of safe nurse staffing coverage and care complexity factors with nursing-sensitive adverse events in cardiac inpatients: a cross-sectional multicenter study"],"prefix":"10.3389","volume":"13","author":[{"given":"Susana","family":"Asensio-Flores","sequence":"first","affiliation":[{"name":"Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL)","place":["Barcelona, Spain"]},{"name":"Faculty of Nursing, University of Barcelona, L\u2019Hospitalet de Llobregat","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Adamuz","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Barcelona, L\u2019Hospitalet de Llobregat","place":["Barcelona, Spain"]},{"name":"Nursing Knowledge Management and Information Systems Department, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Soldevila-Cases","sequence":"additional","affiliation":[{"name":"Hospital Universitari de Bellvitge, L\u2019Hospitalet de Llobregat","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f2nica","family":"Castell\u00e0-Creus","sequence":"additional","affiliation":[{"name":"Quality Department, Hospital Germans Trias I Pujol","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esperanza","family":"Zuriguel-Perez","sequence":"additional","affiliation":[{"name":"Multidisciplinary Nursing Research Group (VHIR), Knowledge Management and Evaluation, Hospital Universitari Vall d\u2019Hebron","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Polushkina-Merchanskaya","sequence":"additional","affiliation":[{"name":"Nursing Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet del Llobregat","place":["Catalonia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Delgado-Hito","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Barcelona, L\u2019Hospitalet de Llobregat","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Eul\u00e0lia","family":"Juv\u00e9-Udina","sequence":"additional","affiliation":[{"name":"Catalan Health Institute, Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"B1","year":"2021"},{"key":"B2","article-title":"Patient safety incident reporting and learning systems: technical report and guidance","year":"2020"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e1285","DOI":"10.1097\/PTS.0000000000000889","article-title":"Evolving factors in hospital safety: a systematic review and meta-analysis of hospital adverse events","volume":"17","author":"Sauro","year":"2021","journal-title":"J Patient Saf"},{"key":"B4","article-title":"Estudio Nacional sobre los Efectos Adversos ligados a la Hospitalizaci\u00f3n. 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