Nurse working conditions
About 14 percent of U.S. hospitals are suffering from a
severe shortage of nurses, with over 20 percent of nursing
positions unfilled. To handle this shortage, many health care
facilities have increased nurses' patient loads or expanded the
use of nonpermanent staff, such as float pool and agency nurses.
Extended work shifts and overtime for nurses also have escalated.
Overwork and fatigue among nurses have been associated with
medication errors and falls, increased deaths, and spread of
infection among patients and health care workers.
Improving the working conditions of registered nurses (RNs) can
potentially decrease the incidence of many infectious diseases
among staff and patients, according to a recent study that was
supported in part by the Agency for Healthcare Research and
Quality (HS13114). For the study, researchers conducted a review
of published research on the nursing workforce and nursing as it
relates to infectious diseases. Their review revealed that a
higher ratio of pool staff to regular nursing staff tends to
increase health care-associated infections, while greater RN
skill mix decreases the incidence.
Without adequate numbers of trained hospital employees to
implement effective infection control procedures, such as hand
hygiene and proper isolation procedures, emergency departments and
hospital wards can easily become venues for the spread of
epidemics. For example, in a study of over 1,500 nurses working in
40 units in 20 hospitals, poor organizational climate and high
workloads were associated with 50 to 200 percent increases in the
likelihood of needle stick injuries (which can transmit infectious
blood pathogens) and near-misses among hospital nurses.
Nurses are concerned about their exposure to infection, and
their perception of unsafe working conditions may hinder their
recruitment and retention. This perception may constrain the
ability of hospitals to deal with future infectious disease
threats, caution the researchers.
See "Nurses' working conditions: Implications for infectious
disease," by Patricia W. Stone, Ph.D., M.P.H., R.N., Sean Clarke,
R.N., Ph.D., C.R.N.P., C.S., Jeannie Cimiotti, R.N., and Rosaly
Correa-de-Araujo, M.D., M.Sc., Ph.D., in the November 2004
Emerging Infectious Diseases 10(11), pp. 1984-1989.
Reprints (AHRQ Publication No. 05-R006) are available from the
AHRQ Publications Clearinghouse.
these are excerpts from the AHRQ Research Activities,
you can read the full report at
http://www.ahrq.gov/research/dec04/1204RA4.htm
|