A study examining the relationship between nurse staffing and patient outcomes to determine whether safety net status affects that relationship found that more nurse staffing prevented patients from poor outcomes in general adult units and intensive care, but that hospitals’ safety-net status complicated those results.
The authors examined the effect of direct nursing care hours and of the proportion of nursing care hours that Registered Nurses (RNs) provided by analyzing data from hospitals in the University HealthSystem Consortium, measuring hours of nursing care per inpatient day.
More nurse staffing hours in non-safety-net hospitals correlated with lower rates of congestive heart failure (CHF) mortality, infection and prolonged hospital stays. Safety-net hospitals with more nurse staffing had lower rates of prolonged hospital stays, but higher CHF mortality. Increased RN care correlated with lower rates of failure to rescue in all hospitals, and with lower rates of infections in non-safety-net hospitals. Nurse staffing hours per inpatient day in intensive care correlated with fewer infections, while RN intensive care correlated with fewer cases of sepsis and failure to rescue.
The authors recommend that hospitals increase nursing hours per inpatient day in both general and intensive care units to reduce prolonged stays and to decrease infections.