Nurse staffing and outcomes

Here's a new summary from AHRQ of how nurse staffing makes a difference in hospital outcomes. There's a particular emphasis on "Nursing-Sensitive Outcomes."

Five studies found at least some association between lower nurse staffing levels and one or more types of adverse patient outcomes. Among the study's principal findings:

In hospitals with high RN staffing, medical patients had lower rates of five adverse patient outcomes (UTIs, pneumonia, shock, upper gastrointestinal bleeding, and longer hospital stay) than patients in hospitals with low RN staffing. Major surgery patients in hospitals with high RN staffing had lower rates of two patient outcomes (UTIs and failure to rescue).

Higher rates of RN staffing were associated with a 3- to 12-percent reduction in adverse outcomes, depending on the outcome.

Higher staffing at all levels of nursing was associated with a 2- to 25-percent reduction in adverse outcomes, depending on the outcome.

Pneumonia rates were found to be especially sensitive to staffing levels.

All adverse events studied (pneumonia, pressure ulcer, UTI, wound infection, patient fall/injury, sepsis, and adverse drug event) were associated with increased costs. Do the math. (Remember quality is free?) Higher staffing levels may save money for the hospital and risk, pain, and aggravation for the patient.

Comments

[Tucson Dunn]

I recently moved from the USA to UK to lead a 450-bed acute care hospital. The hospital operates at a 98.5% occupancy and to my shock had 1:14 nurse-to-patient ratios. No wonder the hospital's average length of stay is 12 days. This is going to be one of the first corrections areas I work on. The interesting thing is that the "finance department" doesn't support hiring more nurse because it's not in the Budget for this year. Little do they know how much money they could save.

[Amy]

Get a life Tucson.

[TSD]

Amy,

Thanks for your thoughts. I know it seems like "hard going" and I should get a real "life" working in a hospital that affords higher staff-to-patient ratios. However, I came to the UK to make a difference and I remain committed to my goals of improving healthcare. We are now starting to make real changes and improvement to our staffing levels. I can already see the improvement in the quality of care and in job satisfaction of nurses. However, we still have a long way to go. Thanks

[A]

Allegations?

[TSD]

My research into MRSA relating to the this topic revealed a direct coloration between Nurse-to-Patient Staffing Ratio's and levels of MRSA within hospitals. The research indicated that the lower the Nurse-to-Patient staffing ratio, the higher degree of MRSA levels. The "allegations" that I was planning to publish these findings are true.