Patient Safety

Scientific research links patient safety to the number of nurses on duty.  Below are five top studies that link patient safety to the number of nurses on duty that’s why Minnesota needs a minimum standard of care to protect patient safety:

Missed Nursing Care, Staffing and Patient Falls  Kalisch, Beatrice J. PhD, RN, FAAN; Tschannen, Dana PhD, RN; Lee, Kyung Hee MPH, RN  Journal of Nursing Care Quality: January/March 2012 – Volume 27 – Issue 1

  • Conclusions: The results of this study demonstrate that the level of nurse staffing predicted patient falls. This supports the findings of previous studies which have reported that higher staffing levels lead to fewer patient falls.16–18 It also reinforces our earlier findings that staffing levels predict the amount and type of missed care.23

Florence Nightingale School of Nursing and Midwifery ResearchKings College, London  Nurse Staffing Tied to Pediatric Readmissions “A ratio of more than 8 patients per RN significantly increases the risk of harm and constitutes a breach in patient safety which should be escalated by RNs for investigation.”  Safe Staffing Alliance Statement, May 2013

Hospital Nursing and 30-Day Readmissions Among Medicare Patients With Heart Failure, Acute Myocardial Infarction, and Pneumonia   McHugh, Matthew D. PhD, JD, MPH, RN; Ma, Chenjuan PhD, RN, Medical Care: January 2013 – Volume 51 – Issue 1 – p 52–59 (Abstract only)

  • Conclusions: Improving nurses’ work environments and staffing may be effective interventions for preventing readmissions.

State-Mandated Nurse Staffing Levels Lead to Lower Patient Mortality and Higher Nurse Satisfaction     Jill Furillo, RN, DeAnn McEwen, RN, AHRQ Health Care Innovations Exchange, September 26, 2012

  • Conclusions: As mandated by California Assembly Bill 394,7 the California Department of Health Services requires acute care hospitals to maintain minimum nurse-to-patient staffing ratios. Required ratios vary by unit, ranging from 1:1 in operating rooms (ORs) to 1:6 on psychiatric units. The legislation also requires that hospitals maintain a patient acuity classification system to guide additional staffing when necessary, assign certain nursing functions only to licensed registered nurses, determine the competency of and provide appropriate orientation to nurses before assigning them to patient care, and keep records of staffing levels. To assist with compliance, the legislation made grants available to hospitals and provided funding to college and university nursing programs to increase the pipeline of new nurses.

Nurse Staffing and Inpatient Hospital Mortality  Jack Needleman, Ph.D., Peter Buerhaus, Ph.D., R.N., V. Shane Pankratz, Ph.D., Cynthia L. Leibson, Ph.D., Susanna R. Stevens, M.S., and Marcelline Harris, Ph.D., R.N. New England Journal of Medicine, 364;11 nejm.org march 17, 2011

  • Conclusions: staffing of RNs below target levels was associated with increased mortality, which reinforces the need to match staffing with patients’ needs for nursing care.

Nurse Staffing and Patient Outcomes in Critical Care: A Concise Review      Aragon Penoyer, Daleen PhD, RN, CCRP, FCCM  Critical Care Medicine: July 2010 – Volume 38 – Issue 7 – pp 1521-1528

  • Conclusions: Findings from this review demonstrate an association of nurse staffing in the intensive care unit with patient outcomes and are consistent with findings in studies of the general acute care population. A better understanding of nurse staffing needs for intensive care unit patients is important to key stakeholders when making decisions about provision of nurse resources. Additional research is necessary to demonstrate the optimal nurse staffing ratios of intensive care units.

Overcrowding and Understaffing in Modern Health-care Systems: Key Determinants in Meticillin-resistant Staphylococcus Aureus Transmission
Archie Clements, et al, Lancet Infectious Disease, July 2008

  • Conclusions:  understaffing of nurses is a key factor in the spread of methicillin-resistant Staphylococcus aureus (MRSA), the most dangerous type of hospital acquired infection. “Overcrowding and understaffing have had a negative effect on patient safety and quality of care, evidenced by the flourishing of health-care-acquired MRSA infections in many countries, despite efforts to control and prevent these infections from occurring. There is an urgent need for a requirement for developing resource allocation strategies that minimize MRSA transmission without compromising the quality and level of patient care,” the researchers concluded. The authors note that common attempts to prevent or contain MRSA and other types of infections such as requirements for regular and repeated hand washing by nurses are compromised when nursing staff are overburdened with too many patients. They also note that hospitals now involve nurses in a “vicious cycle” where a call for nurses to increase their infection control procedures “are seldom accompanied by increases in staffing levels and thus represent an additional work burden on nursing staff” that leads to a greater spread of infections.