The Case for Optimal Nurse Staffing

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The Case for Optimal Nurse Staffing

Two New Studies Show Link to Patient Outcomes

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The Impact of RN Staffing and Hospital Work Environment On Heart Attack Survival

You might assume that a hospital would be the safest place in the world to have a heart attack, but only 15 percent of all patients who suffer in-hospital cardiac arrest (IHCA) survive to be discharged. A new study looks at why — and finds a link between IHCA survival rates, nurse staffing levels and hospital working conditions.

Staffing Ratios Are Important

More than half of all IHCAs occur in the ICU and 80 percent are witnessed. In fact, 88 percent of IHCA patients are on a cardiac monitor at the time of the event. Nevertheless, overall survival rates are poor and vary significantly from hospital to hospital.

Better understanding the reasons why was the goal of a new study published in the January 2016 issue of the journal Medical Care. Since nurses are the first link in the “Chain of Survival” for IHCA, the researchers posited that staffing ratios might play a role.

After examining data for 11,160 patients in 75 hospitals, researchers found that on a medical-surgical unit, each additional patient per nurse correlated with a 5 percent relative reduction in patients’ odds of surviving IHCA.     

Burned Out Nurses Are Not as Effective

Furthermore, hospitals with a poor work environment — measured based on standardized survey responses regarding leadership, support and nurse participation — had a 16 percent lower IHCA survival rate than did hospitals with better work environments.           

Saving a patient undergoing cardiac arrest requires close monitoring and immediate response, which are more difficult for nurses who are stressed or overloaded.

Lead researcher Matthew McHugh, RN, Ph.D., J.D., MPH, associate director of the University of Pennsylvania School of Nursing Center for Health Outcomes and Policy Research, says the results of the study “add to a large body of literature suggesting that outcomes are better when nurses have a more reasonable workload and work in good hospital work environments.”

You can access the study here.



ANA White Paper Provides Evidence to Support Optimal Nurse Staffing

Even in states like California, which mandates minimum nurse-to-patient ratios, nurses can play an important role in ensuring that their facilities maintain safe staffing levels. To that end, the American Nurses Association (ANA) has released a white paper on nurse staffing designed to serve as an advocacy aid for nurses at any level.

Necessary and Appropriate

The white paper, prepared for the ANA by Avalere Health, LLC, presents research showing the impact nurse staffing has on quality of care, patient outcomes and even a hospital’s financial stability.

The paper also discusses the recent developments in the healthcare world, such as an aging patient population and the new reimbursement models introduced by the Affordable Care Act, that are moving the bar of what is necessary and appropriate when it comes to staffing.

Empowering Advocacy

ANA President Pamela Cipriano, RN, Ph.D., NEA-BC, FAAN, says that nurses need to play an active role in setting those standards. “Nurses on the front lines are in the best position to determine the staffing needed for safe, equitable and quality care,” she says. “This white paper is our way of providing evidence to support the need for changes in nurse staffing across all healthcare settings.”

“We need to be able to tell our boards of trustees and other administrators: ‘If we want to be able to deliver quality care to our community, then here is the staffing we need and here is the evidence,’” adds Bob Dent, RN, DNP, senior vice president and chief operating officer at Midland Memorial Hospital in Texas.

Download the white paper from the ANA website.   

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