Short Nurse Staffing Linked to Higher Patient Mortality

More deaths seen when shifts fall eight or more hours below target

WEDNESDAY, March 16 (HealthDay News) -- Patient mortality appears to be higher when nurse staffing falls eight or more hours below target level and during nursing shifts when patient turnover is high, according to research published in the March 17 issue of the New England Journal of Medicine.

Jack Needleman, Ph.D., of the University of California in Los Angeles, and colleagues analyzed data on 197,961 admissions and 176,696 eight-hour nursing shifts in 43 hospital units to look for an association between mortality and nursing shifts in which staffing by registered nurses (RNs) falls eight hours or more short of the staffing target.

The researchers found that 84 percent of shifts had RN staffing within eight hours of the target level, and 93 percent of shifts had patient turnover within one standard deviation of the day-shift mean. There was a significant association between increased mortality rate and increased patient exposure to unit shifts that fell eight or more hours short of target (hazard ratio per shift eight hours or more below target, 1.02). There was also a significant association between higher mortality and high patient turnover (hazard ratio per high-turnover shift, 1.04).

"In this retrospective observational study, staffing of RNs below target levels was associated with increased mortality, which reinforces the need to match staffing with patients' needs for nursing care," the authors write.

A co-author disclosed financial ties to the Johnson & Johnson Campaign for the Future of Nursing.

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