April 27, 2001

Nursing shortage hurts patients

Featured Image

Stuart G. Finder, Ph.D., right, talks with Mark J. Bliton, Ph.D., in his office in Oxford House. Finder is the director of the Center for Clinical and Research Ethics. (photo by Neil Brake)

Nursing shortage hurts patients

A Vanderbilt University School of Nursing researcher has found a direct correlation between nurse staffing and patient health and survival, according to a study released by the U.S. Department of Health and Human Services.

The findings from the report, the most comprehensive to date on the topic, show that low nurse staffing directly impacted patient outcomes ranging from urinary tract infections, shock and bleeding.

“This is the largest and most sophisticated study to date concerning the relationship between hospital nurse staffing and patient outcomes,” said the study’s co-director, Peter Buerhaus, Ph.D., RN, FAAN, senior Dean for Research and Valere Potter Distinguished Professor of Nursing at Vanderbilt University School of Nursing.

“We have provided the evidence that nursing staff matter in what happens to patients. Perhaps the results will enable us to move health policy forward and make it possible to provide hospitals and nurses with the kind of resources that will enable them to enrich staffing levels to the point where the adverse patient outcomes we found can be reduced,” he said.

The study, “Nurse Staffing and Patient Outcomes in Hospitals,” was directed by Jack Needleman, assistant professor of Economics and Health at Harvard School of Public Health.

The researchers, utilizing 1997 data from more than 5 million patient discharges from 799 hospitals in 11 states, found that there were consistent relationships between nurse staffing variables and five adverse patient outcomes – urinary tract infections, pneumonia, shock, upper gastrointestinal bleeding and length of hospital stay in medical and major surgery patients.

The report also showed higher RN staffing was associated with a 3 to 12 percent reduction in certain adverse outcomes and higher staffing at all levels of nursing was associated with a 2 to 25 percent reduction in adverse outcomes.

This study comes nearly one year after Buerhaus released a study in the Journal of the American Medical Association projecting that the pool of registered nurses will fall drastically by the year 2020. In comments about the impending shortage, Buerhaus said that the consequences of the lack of staffing put patient care at risk.

“This is an emerging crisis,” he said concerning the shortage. “As that occurs, the demand for health care will increase at a high rate, yet the RN workforce will be decreasing. Clearly, this will create a threat to the access and quality of health care.”

According to the newest study, the costs associated with patient complications can be substantial. Reductions in the rates of adverse outcomes reduce hospital costs as well as significant financial and psychological costs to patients and their families.

It is Buerhaus’ hope that these additional study results will help shape health policy, focusing much needed attention on developing solutions to the nursing shortage and ways to tackle staffing levels in relation to patient care outcomes.

“Improving patient safety is a critical issue and our study puts the impact of staffing mix and levels before the nursing profession, hospital industry, insurers and policy makers,” he said. “It now remains to be seen what they will do.”

Buerhaus will be in Washington on May 16 to deliver a congressional briefing on the nursing shortage.