The Mayo Clinic, the Vanderbilt University and UCLA School of Public Health have jointly determined that as the number of nurses’ decrease, patients’ mortality risk rises. This study also details that patient mortality increases when additional workload is placed on nurses during shifts. The research results are based on a study of 198,000 patients and 177,000 eight-hour nursing shifts across 43 patient-care units in the U.S. Read on to know more.
Studies Conducted On Compromised Patient Care And Mortality Levels
1. Impact of unit-level nurse workload on patient safety: This ongoing project aims to assess the relationship between daily changes in hospital working conditions and medical errors. These daily changes include nurse staffing ratios, workload, and mix of skilled and unskilled nurses.
2. Direct relation of nurses’ working conditions to patient outcomes: This project takes a good look at occurrence of adverse patient outcomes and the kind of nursing care given. Everything that affects nursing care such as job strain, risk of injury, workloads, hospitals’ use of overtime, use of unskilled contract nurses and so on were studied to arrive at the proper metrics.
3. The impact of nurses’ working conditions on medication safety: This project describes how nurses’ workload, nurses’ working conditions, adherence to medication standards, and other variables affecting nurses are related to the quality and safety of patient care. The physical environment, automation aspects, staffing levels and safety climate comprise the physical working conditions of nurses.
4. The relation between total hospital workload to patient safety: This project examines the association between hospital workload and the adverse drug events that occur. The study assesses whether overall hospital workload should be limited, or whether task processes should be reorganized during times of high workload pressure improve patient safety. Researchers and investigators review electronic medical records use to develop new methods to identify adverse events that are related to overall hospital workload.
Patient Mortality Related To Inadequate Nurse Staffing Levels
As part of their comprehensive analysis, the researchers calculated the difference between the target nurse-staffing level and the actual nurse-staffing level for each shift they examined. What the researchers found was that for each substantially understaffed shift, patients’ overall mortality risk increased by 2 percent. An average patient is exposed to at least three nursing shifts a day; given these rates, the mortality risk is about 6 percent higher than in fully staffed units.
It’s a known fact that health care centers that have low nurse staffing levels show a higher percentage of poor patient outcomes such as shock, cardiac arrest, urinary tract infections and pneumonia. The Agency for Health care Research and Quality (AHRQ) has conducted several studies to establish this fact in major hospitals. Apart from sicker patients, nursing shortage per shift actually contributes to patient mortality. Going by several recent studies that have been sparked by the much-publicized nursing shortage in the US, it appears that the ‘failure to rescue’ syndrome owing to nursing shortage does cause unnecessary patient deaths.
Patient Mortality Risk Related To High Nurse Workloads
Apart from the above, the study also discovered that during times of high patient turnover, nurses’ workloads increase. As a direct result of the nursing shortage combined with high workloads, mortality risk also increases. For each nursing shift during high patient turnover times, the mortality risk was 4 percent higher per shift.
Nurses as we know are the front-line caregivers in any hospital. They coordinate and provide direct care and are responsible for every aspect of patient care. Every hospital in the world has a goal to ensure that each of its patient-care units is staffed by an adequate number of nurses for every shift.
Nurse shifts should ideally be adjusted each shift, depending on incoming and outgoing patients and their care requirements. While having more nurses than is really required can be expensive for hospitals and affect the profit margin, having too few nurses on staff can actually put patients’ health in danger.
Tips To Improve Nursing Staff And Lower Risks
Given the huge nursing shortage, it’s hard to hire new nurses so that there are enough nurses to give patients the care they deserve. However, there are a few things hospitals can do to subvert the serious situation of hospital mortality.
1. Rehire retired senior nurses to work part time. Not only will this help reduce the nursing shortage, but also having experienced senior nurses around will help younger nurses learn to cope better with daily stresses. Rehiring retired nurses also helps you ensure an adequate number of nurses per shift.
2. Improve your nursing staff’s morale. Asking nurses to do too much owing to nursing shortage can stress them out considerably, but if they’re taxed without thanks, morale reduces. Ensure that you appreciate your nursing staff regularly, and demonstrate your gratitude for their dedication via simple acts of kindness and appreciation. This will help reduce the stress, conflict, low morale and staff turnover.
3. Use automated patient monitoring machines so that the condition of critical patients can be monitored remotely from nursing stations and staff rooms. This will ensure that patients are not left alone when they are in a critical condition.
4. Conduct refresher courses to ensure that nurses adhere to medication standards. Attach monetary rewards to the staff members who adhere to all medication standards. This will bring down patient mortality risk owing to medication-related accidents, and also raise staff morale.
5. Anticipate the times of high patient turnover and schedule nursing shifts and workloads accordingly. For example, your hospital might see a sudden influx of accident victims when the roads are iced over. Make a list of such times and work out solutions with your staff.
6. Evaluate the skills of your nursing staff. Place only skilled and experienced nurses in charge of critically ill patients. Make sure your less skilled nurses, or those unskilled in specialty areas are either relocated to other departments or put through the relevant training courses.
