May 4th and 5th 2017, Nurses from around the country will converge on Washington DC for a Patient Safety Conference and to rally for safe Nurse:Patient Staffing. The Patient Safety Conference and the Rally is being held by Nurses Take DC, a grassroots movement led by Show Me Your Stethoscope, in order to raise awareness to safe Nurse:Patient staffing and to support pending legislation.
The charge for safe staffing is not a new concept. Twenty years ago Nurses took to the Nation’s capital to rally for safe staffing, but after twenty years, staffing matrices are still not adequate everywhere. Studies have shown that lower Nurse:Patient ratios are linked to improved outcomes, while greater numbers of patients per Nurse are linked to worse outcomes. An observational study done in 2013, in the BMJ Quality and Safety in Healthcare journal, showed that adding a single pediatric patient to the current common ratio increased 30 day readmission risk by 11% while the risk increased by 50% for surgical pediatric patients. Likewise, JAMA Pediatrics showed that inadequate staffing in the NICU resulted in higher nosocomial infections. Nosocomial infections are infections and diseases acquired while in the hospital.
Poor outcomes and mortality are not only seen in Pediatric populations. Adults, even adults with some of the most common ailments afflicting the US population, are also at risk. An article appearing in the journal Medical Care showed that each additional patient above adequate staffing levels increased 30-day readmission rates for patients with heart failure by 7%, for patients that suffered an acute myocardial infarction (heart attack) by 6%, and for patients with pneumonia by 10%. The New England Journal of Medicine conducted a study of 190,000 patients, producing evidence tying nurse staffing to chances of death. The study concluded that the risk of death increases by 2%-4% for each eight-hour shift where staffing is not adequate for the patient acuity, the mix of the patients, and/or to handle times of high patient turnover.
Finally, the Agency for Healthcare Research and Quality reviewed research related to California’s law mandating staffing minimums for Nurses and compared those ratios to other hospitals in the nation. AHRQ found that 30-day readmission rates and mortality rates due to preventable medical complications increased by approximately 7% for every patient per Nurse above the California ratios. AHRQ also found that
A meta-analysis of 90 studies found that increased registered nurse (RN) staffing was associated with lower mortality on intensive care, medical, and surgical units; reduced risk of hospital-acquired pneumonia, unplanned extubation, respiratory failure, cardiac arrest, and failure to rescue; and shorter lengths of stay for surgical (31 percent) and intensive care unit (ICU) patients (24 percent).
Patients are not the only individuals impacted by high Nurse:Patient ratios. The same AHRQ document found that Nurses are also impacted. Each additional patient above the California ratios resulted in a 23% increase in Nurse-reported burnout, and a 15% increase in Nurses reporting being dissatisfied with their job. AHRQ concludes that staffing ratios, such as those in California, are linked to lower patient mortality and increased Nurse and Patient satisfaction.
The research seems to point to a need for organizations and States to adopt minimum safe staffing ratios in order to protect both patients and Nurses. Some organizations and States have already done this on their own, however, in this time of healthcare reform and change, it may be time for Federal legislators to take a look at California’s legislation, and the research supporting it, and act on behalf of patients and those caring for them.
If you want to attend the Conference or the Rally follow the links listed below and reserve your spot. The conference has secured special hotel rates at the Sheraton, which is also listed below
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