Replacing registered nurses with non-RN staff is dangerous for patients, according to a new study from the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing, published in Medical care.
WHY IT MATTERS
To assess how the struggle to recruit and retain hospital nurses impacts patients, researchers looked at data on patient outcomes, 30-day mortality rates, 30-day readmissions, length of stay and patient satisfaction at 2,676 U.S. general acute care hospitals in 2019.
After conducting a cross-sectional analysis of three linked data sets from the American Hospital Association Annual Survey, Medicare Provider Analysis and Review patient claims and Hospital Compare’s Hospital Consumer Assessment of Healthcare Providers and Systems, the researchers said the workforce reduction translated to 11,000 . deaths and higher avoidable Medicare costs.
Most hospitals they studied had more than 70% RNs in their total nursing staff.
“However, we can predict from our models that a 50 percentage point reduction in RNs, compared to our observed average of 76.5% RNs, would be associated with 38% higher odds of in-hospital mortality, 24% higher odds of 30-day mortality.” mortality, 6% higher chance of readmission and 10% longer expected length of stay,” they said in the abstract.
Further, a 10 percentage point reduction in RNs translates into $68.5 million in avoidable costs paid by Medicare, they said.
“Estimates represent only a skills mix dilution of 10 percentage points. However, the team nursing model involves much larger reductions of 40-50 percentage points – the human and economic impacts of which could be significant.”
THE BIG TREND
Nationally, nurse groups are concerned about nurse-to-patient ratios and oppose laws requiring minimum nurse staffing levels, citing risks to patient care.
Nurses at Ascension Saint Agnes Hospital in Baltimore, Maryland, rallied Thursday in support of workforce protections proposed to hospital management during recent contract negotiations, National Nurses United said.
“Due to Ascension’s pattern of closing obstetrics, labor and delivery services across the country, we believe these ‘Patients First’ protections should be ensured through our contracts,” said Nicki Horvat, a neonatal intensive care nurse and member of the negotiating team, in one rack.
NNU also said yes January report found that Ascension has downsized a quarter of its labor and delivery units over the past decade, impacting metropolitan and other areas with higher numbers of low-income Black and Latino patients, at a time when mortality rates from pregnancy and childbirth increased.
ON THE RECORD
“Reducing the number of RNs in hospitals, even if total nursing staff hours remain the same, will likely result in significant preventable patient deaths, readmissions, increased length of stay, and decreased patient satisfaction, in addition to additional Medicare costs and foregone costs. savings for hospitals,” the researchers said.
Andrea Fox is editor-in-chief of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.