Longitudinal Analysis of Nurse-Sensitive Outcomes and Their Predictors Across Tertiary Hospitals in South South Nigeria

Background: Nurse-sensitive outcomes, defined as patient outcomes significantly influenced by nursing care quantity and quality, have not been longitudinally mapped across Nigerian tertiary hospitals, limiting accountability frameworks for nursing care. Aim: This study conducted a longitudinal analysis of nurse-sensitive outcomes and their predictors across tertiary hospitals in South South Nigeria. Methods: A longitudinal observational design collected quarterly data over three years from five teaching hospitals in Rivers, Cross River, and Delta States. Nurse-sensitive outcome indicators including falls, pressure ulcers, catheter-associated urinary tract infections, and 30-day readmissions were extracted from hospital information systems. Mixed-effects multilevel models identified outcome predictors. Results: Significant between-hospital variability was observed across all nurse-sensitive outcomes. Nurse staffing adequacy, staff turnover rates, and continuing professional development participation were independent longitudinal predictors. Facilities with nursing quality committees showed significantly lower adverse event trajectories over the observation period. Conclusion: Nurse-sensitive outcomes are measurable and modifiable through nursing system investments in Nigerian tertiary hospitals. The study provides empirical grounding for a national nurse-sensitive outcome monitoring framework and nursing quality accountability mechanisms. Keywords: nurse-sensitive outcomes, longitudinal study, South South Nigeria, patient safety, nursing quality.