Hospital Nurse Staffing and Quality of Care
Hospitals with low nurse staffing levels tend to have
higher rates of poor patient outcomes such as pneumonia,
shock, cardiac arrest, and urinary tract infections, according to
research funded by the Agency for Healthcare Research and Quality
(AHRQ) and others.
Although hospitals with low nurse staffing levels tend to have
higher rates of poor patient outcomes,
increasing staffing levels is not easy. Major factors
contributing to lower staffing levels include the needs of today's
higher acuity patients for more care and a nationwide gap
between the number of available positions and the number of
registered nurses (RNs) qualified and willing to fill them.
This is evident from an average vacancy rate of 13 percent.
According to a 2002 report by the workforce commission of the
American Hospital Association, the nursing shortage "reflects
fundamental changes in population demographics, career
expectations, work attitudes and worker dissatisfaction."1
In fact, the present situation may well continue over the next
two decades. A Federal Government study predicts that hospital
nursing vacancies will reach 800,000, or 29 percent, by 2020.2
The number of nurses is expected to grow by only 6 percent by
2020, while demand for nursing care is expected to grow by 40
percent.
Hospitals that increase their nurse staffing ratios either
across all units or within individual units have reason to be
concerned about the impact of such steps on their finances.
However, a new study finds that increased staffing of RNs does
not significantly decrease a hospital's profit, even though it
boosts the hospital's operating costs. A 1-percent increase in RN
full-time equivalents increased operating expenses by about 0.25
percent but resulted in no statistically significant effect on
profit margins. In contrast, higher levels of non-nurse staffing
caused higher operating expenses as well as lower profits.21
Some hospitals may choose to increase nurse staffing levels.
According to the authors of one study: "The implications of doing
nothing to improve nurse staffing in low staffed hospitals are
that a large number of patients will suffer avoidable adverse
outcomes and patients will continue to incur higher costs than are
necessary."19
these are excerpts from the Research in Action, Issue 14, By
Mark W. Stanton, M.A.,
you can read the full report
here
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