INQRI Team's Research Links Nurse Staffing to Readmission Rates
Research by the Robert Wood Johnson Foundation (RWJF)-funded Interdisciplinary Nursing Quality Research Initiative (INQRI) team at Marquette University has found that hospitals with more registered nurses working on a unit and fewer R.N. overtime hours have lower rates of patient readmission and fewer post-discharge visits to the emergency department.
Marquette’s Marianne Weiss, D.N.Sc., R.N.; Olga Yakusheva, Ph.D.; and Kathleen Bobay, Ph.D., R.N., N.E.A.-B.C., studied nurse staffing levels, patients’ reports on quality of the discharge teaching process and their readiness for discharge, along with post-discharge readmissions and emergency department visits for 16 medical-surgical units at four hospitals in a single Midwestern health care system. They found that when R.N. non-overtime staffing was higher, the odds of patient readmission were lower, and that when R.N. overtime hours were higher, post-discharge emergency department use was also higher.
“We know that patients who aren’t properly prepared to be discharged are more likely to be readmitted to the hospital, and we also know that if nurses have more hours allocated to work with patients, they have more time to perform critical functions that require R.N.- level expertise, like discharge teaching,” said Weiss. “This study shows us that investing in nursing care hours could potentially be offset by the savings that could be realized in reductions in readmission and emergency department use.”
The study also found a positive correlation between the number of R.N. staffing hours and patients’ satisfaction with the quality of discharge teaching and subsequent readiness to go home.