In two studies, it was hypothesized that the amount or
quality of clinical support for nurses providing direct care
was related to hospital mortality rates. Knaus et al. (1986)
reported that intensive care units in American hospitals with
the lowest mortality rates had comprehensive nursing
educational systems such as clinical nurse specialists, and
that those with the highest mortality rates did not have such
clinical support systems. Tourangeau et al. (2002) found no
evidence of a relationship between the amount of nurse reported
clinical support and mortality rates in Ontario
hospitals.