Unit-based nurse floating and nurse-sensitive indicators

ABSTRACT Background: Unit-based nurse floating, defined as reassigning nurses from their home unit to another unit to meet staffing needs, remains a common staffing strategy; however, its relationship with nurse-sensitive indicators (NSIs) remains unclear. Purpose: To examine the association between unit-based nurse floating frequency and four NSIs: falls, pressure injuries, central line–associated bloodstream infections (CLABSIs), and catheter-associated urinary tract infections (CAUTIs), at the unit level. Methods: A cross-sectional study was conducted using 1 year of data from 25 adult inpatient units across three hospitals. Floating frequency was collected from staffing records, and NSI data were obtained from the National Database of Nursing Quality Indicators® reports. Logistic regression was used to estimate associations. Results: A total of 12,042 float shifts were identified. Higher floating frequency was associated with increased odds of pressure injuries (third quartile: OR, 2.81; 95% CI, 1.03-7.65; fourth quartile: OR, 3.31; 95% CI, 1.24-8.80). No significant associations were found for falls, CLABSIs, or CAUTIs. Conclusions: Floating varied across units and was associated with pressure injuries at the home-unit level. Floating unit nurses should be considered a measurable staffing variable. Nurse managers should examine floating patterns and evaluate policies and support in place for floated nurses.