nurse staffing issues - patient care
Researchers are studying the relationship between nurse
staffing levels and nursing-sensitive patient outcomes
The many financial pressures placed on hospitals as well as the
drive to use outpatient care whenever possible have resulted in
fewer nurses taking care of more severely ill patients during ever
shorter hospital stays. What's more, nonprofessional and
unlicensed personnel such as nurse's aides are replacing
registered nurses (RNs) in patient care roles at many hospitals.
These developments are at the root of widely reported concerns
that the workload of RNs is increasing, jobs are disappearing,
morale is declining, and quality of care is worsening. Concerns
about hospital quality of care led California to enact legislation
in October 1999 that set mandatory hospital nurse staffing levels.
Despite such concerns about the impact of reductions in
staffing levels on the quality of hospital care, there has been
little evidence linking changes in the hospital nurse workforce to
potentially adverse effects on patient outcomes. This research
issue is now being addressed by eight federally funded studies,
which are summarized in a recent paper by Peter I. Buerhaus,
Ph.D., R.N., F.A.A.N., and Jack Needleman, Ph.D., of Harvard
University, whose work is supported by the Agency for Healthcare
Research and Quality (HS09958). Once completed, these studies,
which include four supported by AHRQ, should provide a richer
understanding of which patient outcomes, both good and bad, are in
fact sensitive to nursing. This, in turn, will enable hospital
administrators to better understand the consequences of
restructuring and staffing decisions and how different
organizational models of nursing affect outcomes.
For more information, see "Policy implications of research on
nurse staffing and quality of patient care," by Drs. Buerhaus and
Needleman, in the March 2000 Policy, Politics, and Nursing
Practice 1(1), pp. 5-15.
Reprints are available from the AHRQ Publications
Clearinghouse.
These are excerpts from the AHRQ Research Activities,
you can read their full reports at
http://www.ahrq.gov/research/mar00/0300ra28.htm |