Staffing, Quality, and Costs

The New York State Nurses Association is supporting a bill currently under discussion in the New York state legislature that would establish required nurse staffing ratios in the state's 185 acute care hospitals.  The hospitals oppose the bill, noting that the suggested ratios would cost their institutions and nursing homes about $3 billion a year and would affect their ability to shift staff use as needed.

This is an important conversation, given that research is demonstrating that nurse staffing levels have a definite impact on the quality of patient care.

INQRI researchers Mary Blegen and Tom Vaughn examined the extent to which nurse staffing levels affected the incidence of complications and the failure to rescue from those complications, (i.e. death following complications). Their examination showed that nursing hours per patient day were strongly associated with lower rates of pressure ulcers and hospital acquired infections, and fewer deaths from complications. Further, more RN hours in the mix had additional benefit with still lower rates of failure to rescue and hospital acquired infections. Their work shows that higher levels of nursing hours per patient day and RN skill mix in intensive care units and in general units will lead to better patient outcomes, information that can guide states considering regulation of nurse-patient staffing ratios to address patient safety gaps.

Findings from the first study to look at the link between nursing and very low birthweight infants in the neonatal intensive care unit (NICU) indicate that nurse staffing and practice environment do matter. INQRI researchers Eileen Lake and Jeannette Rogowski examined care in more than 100 NICUs around the U.S. and found that when babies are treated in units where nurses have less support and less frontline experience they are at higher risk of developing infections. Babies in hospitals where nurses are supported and have more experience are less likely to have medical complications such as bleeding in the brain, which leads to costly complications. The study results could guide decisions related to setting standards for all hospitals to follow when creating and staffing a neonatal intensive care unit where infants thrive.

Click here to read an article about the New York legislation in the Wall Street Journal.
Click here to learn more about the Blegen-Vaughn study.
Click here to learn more about the Lake-Rogowski study.