What’s New in the Patient Safety World
April 2011
Nursing Staffing
and Mortality
Many articles have been written about the relationship
between low nursing staffing levels and a variety of adverse events and patient
mortality. Many have been criticized because of the methodologies or data
sources used. A new study (Needleman 2011)
uses an improved methodology and corrects for many of the concerns of previous
studies and concludes that both low nursing staffing levels and that higher
than normal nursing workloads also correlate with increased patient mortality
rates.
The authors looked at data from a large academic medical
center that, in general, had relatively good nurse staffing rates. They were
able to quantify nurse staffing on a shift-to-shift and unit-by-unit basis and
match this to both patient census and workload (as measured by patient turnover
rates). They demonstrated a significant correlation between patient mortality
rates and patient exposure to 3 or more shifts with below-target nursing
staffing or 3 or more shifts with high patient turnover.
This study, in conjunction with the numerous prior studies,
should leave little doubt about the importance of matching nursing staffing
levels to the needs of patients (both census and acuity).
Refereneces:
Needleman J, Buerhaus P, Pankratz
VS, et al. Nurse Staffing and Inpatient Hospital Mortality. N Engl J Med 2011; 364:1037-104
http://www.nejm.org/doi/full/10.1056/NEJMsa1001025
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