Nurse shortages impact patient mortality!!!

Nursing shortages in hospitals have a direct impact on patient mortality rates, a new US study has found.

According to researchers, nurses are the frontline caregivers to hospital patients and the goal for any hospital is to ensure that all of its units have an adequate number of nurses during every shift.

Ideally, the proper number of hours nurses work - known as the ‘target level' - should be adjusted for each shift, depending on the ebb and flow of patients and their need for care. Too many nurses can be costly for hospitals, but too few can put a patient's health in danger.

The researchers analysed the records of nearly 198,000 admitted patients and 177,000 eight-hour nursing shifts across 43 patient care units at a large hospital in the US. They calculated the difference between the target nurse staffing level and the actual nurse staffing level for each shift they examined.

They found that for each shift patients were exposed to that was substantially understaffed - falling eight or more hours below the target level - patients' overall mortality risk increased by 2%. Because the average patient in the study was exposed to three nursing shifts that fell below target levels, the mortality risk for these patients was about 6% higher than for patients on units that were always fully staffed.

The study also found that when nurses' workloads increased because of high patient turnover in individual units, mortality risk also increased. In fact, for each shift in which the number of admissions, discharges and transfers were substantially higher than usual, the risk of mortality among patients was 4% higher.

The average patient in the study was exposed to one high turnover shift.

"Since the hospital we studied delivers high quality care, has low mortality rates, has high nurse staffing targets and meets its targets over 85% of the time, it's unlikely the increased mortality we observed is due to general quality problems. We believe that these findings apply to all hospitals where staffing is generally high and targets are usually met," the researchers said.

In recent years, the Irish Nurses and Midwives Organisation (INMO) has continually highlighted the impact of nursing shortages in Irish hospitals. Following Dr James Reilly's recent appointment as Minister for Health, the organisation called on him to immediately amend the recruitment moratorium that is currently in place within the health system.

This ‘crude' moratorium, it said, is having a ‘corrosive and damaging effect on patient care'.

In an interview with Irishhealth.com, Minister Reilly ruled out lifting this controversial staff moratorium. However, he said it would be made more flexible in order to maintain frontline staff.

Details of the US study are published in the New England Journal of Medicine

[Posted: Sun 20/03/2011 by Deborah Condon - www.irishhealth.com]