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When Nurse Staffing Drops, Mortality Rates Rise: Study
Date:3/17/2011

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, March 16 (HealthDay News) -- When nurse staffing levels fell below target levels in a large hospital, more patients died, a new study discovered.

The finding may provide guidance in an era of nursing shortages and cost-cutting, in that the focus should shift from cost to patient safety, said the authors of the research, appearing in the March 17 issue of the New England Journal of Medicine.

"Hospitals need to know what their nursing needs are for their patients, and they need to bring staffing into line," said study senior author Jack Needleman, a professor of health services at the School of Public Health of the University of California Los Angeles.

"Patients are entitled to be safe in the hospital and to have care delivered reliably and to have nurses with enough time to make sure they aren't developing avoidable complications with permanent consequences," Needleman said.

Previous research has suggested that this might be the case, but many of those studies were dismissed in part because of methodology flaws.

"People had thought maybe [adverse consequences] were due to something else, maybe the quality of the nurses, quality of the doctors, technology, equipment or the hospital doesn't have a commitment to quality," Needleman explained.

For this study, the authors looked at almost 200,000 admissions and about 177,000 nursing shifts at 43 patient units at one hospital that generally had high staffing targets.

Presumably, different areas of the hospital had the same quality of nurses, doctors, technology and equipment, thus eliminating these factors as the source of problems.

Units were considered properly staffed if nursing staffing fell within eight hours of the target level.

When units were understaffed, patient mortality increased by 2 percent. On average, a patient stayed in the hospital for three shifts and when th
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