Print PDF version
Whats New in the
Patient Safety World
August 2024
RN Staffing and Patient
Outcomes
Weve done many columns showing the impact of nursing staffing levels on patient outcomes. But it turns out that the composition of the nursing team (skill mix) is very important. Specifically, reducing the proportion of registered nurses (RNs) by hiring more licensed practical nurses or unlicensed assistive personnel in acute hospital care is linked with more deaths, readmissions, longer hospital stays, poorer patient satisfaction, and higher costs of care.
Lasater et al. (Lasater 2024) found that a 10 percentage-point reduction in RNs was associated with 7% higher odds of in-hospital death, 1% higher odds of readmission, 2% increase in expected days, and lower patient satisfaction. Those authors estimate a 10 percentage-point reduction in RNs would result in 10,947 avoidable deaths annually and 5207 avoidable readmissions, which translates into roughly $68.5 million in additional Medicare costs. Hospitals would forgo nearly $3 billion in cost savings annually because of patients requiring longer stays.
They analyzed data from the American Hospital Association for staffing patterns and Medicare for patient outcomes, and HCAHPS data for patient satisfaction.
The numbers are quite similar to those previously reported by these University of Pennsylvania School of Nursing researchers that we reported in our January 2022 What's New in the Patient Safety World column Another Striking Nurse Staffing Study. They emphasize the importance of being able to staff and retain RNs and show that cost-cutting in the short term may have longer term consequences.
Some of our other columns on nursing workload and missed
nursing care/care left undone:
November 26, 2013 Missed Care: New Opportunities?
May 9, 2017 Missed Nursing Care and Mortality Risk
March 6, 2018 Nurse
Workload and Mortality
May 29, 2018 More
on Nursing Workload and Patient Safety
October 2018 Nurse
Staffing Legislative Efforts
February 2019 Nurse
Staffing, Workload, Missed Care, Mortality
July 2019 HAIs and Nurse Staffing
September 1, 2020 NY State and Nurse Staffing Issues
February 9, 2021 Nursing Burnout
August 2021 The New NY State Law on Nursing Staffing
January 2022 Another Striking Nurse Staffing Study
June 2024 More on Missed Nursing Care
June 2024 AACN Standards for Critical Care Staffing
References:
Lasater KB, Muir KJ, Sloane DM, et al. Alternative Models of Nurse Staffing May Be Dangerous in High-Stakes Hospital Care. Medical Care 2024; 62(7): 434-440, July 2024
Print PDF version
http://www.patientsafetysolutions.com/
Whats New in
the Patient Safety World Archive