Print “PDF version”
What’s New in the
Patient Safety World
November 2022
Nurse Staffing
Composition and Patient Mortality
We’ve done lots of columns on the impact of nursing staffing
levels on patient mortality and other quality outcomes (see list below). A new
study from the UK confirms that better nurse staffing ratios are associated
with lower inpatient mortality rates. But it also shows that the composition of
that nursing staffing is important.
Zaranko et al. (Zaranko
2022) studied inpatient mortality and nursing staffing patterns at
three NHS hospitals. On average, an extra 12-hour shift by an RN was associated
with a reduction in the odds of a patient death of 9.6%. Moreover, an
additional senior RN had 2.2 times the impact of an additional less senior RN. There
was no association for healthcare support workers (HCSW’s) or agency workers. The
authors suggest that the lack of association for HCSW’s and agency nurses
indicates they are not effective substitutes for RN’s who regularly work on the
ward.
The authors note that this study is the first to show the
differential impacts of RN’s by seniority. They state
that their results “demonstrate the value of ensuring and retaining an adequate
number of regularly employed RN’s, show the significant value of senior, more experienced
nurses who provide team leadership and, ultimately, highlight areas to target when
mobilizing extra resources.”
Retention of nurses is an important goal for all healthcare
organizations. We put considerable resources into the training of our nurses
and then sometimes lose them to other organizations that offer them better pay
or better working environments. It is important for hospital administrators to
recognize the “return on investment” in retaining our nurses. Particularly
during this era where we predict an impending nationwide shortage of nurses, we
need to focus on improving working conditions for our nurses to prevent
burnout.
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 “HAI’s
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”
References:
Zaranko B, Sanford NJ, Kelly E, et.
Nurse staffing and inpatient mortality in the English National Health Service:
a retrospective longitudinal study. BMJ Quality & Safety 2022; Published
Online First: 27 September 2022
https://qualitysafety.bmj.com/content/early/2022/09/27/bmjqs-2022-015291
Print “PDF version”
http://www.patientsafetysolutions.com/
What’s New in
the Patient Safety World Archive