In a cohort of over 600,000 hospitalized patients, each day of low RN staffing was associated with an increased risk of death within 30 days of admission (adjusted HR 1.08, 95% CI 1.07-1.09), as was each day of low nurse support staffing (aHR 1.07, 95% CI 1.06-1.08), reported Peter Griffiths, RN, PhD, of the University of Southampton, and co-authors in JAMA Network Open.
While these findings aren’t novel, knowing the level of nurse staffing for every single day of a patient’s stay makes it more likely that the findings are causal, Griffiths told MedPage Today. Of note, when low staffing was prevented with the use of temporary staff, the risk of patient death was reduced but remained elevated compared with the baseline, the authors said.
I imagine this is one of those studies where laymen like me will be tempted to say “well, that was obvious, why’d they study that?” before thinking twice.
It says that the findings aren’t novel, which I think means this is a confirmation of a phenomenon that was found before. It’s good that this kind of thing is quantifiable and reproducible. Hopefully it helps contribute to more funding for public health and better conditions for nurses and other healthcare workers.
In a work environment where higher ups are doing system planning, they don’t really get the point unless it is quantified. If they can’t count it, then it doesn’t count.
The study is from England, where the healthcare system is struggling at the moment. Patients spend the whole day on a trolley or on a chair or in an ambulance because there are no beds and you can’t close a hospital when it gets overloaded. Planners think they can get the same nurses to handle the workload. Planners won’t see that this is causing deaths till someone counts like this and shows them. Even then there’s no funding, there are no nurses on the market to employ and there’s no good solution.
Although this finding looks obvious, the point needs to keep being made to try to push for change.
The other thing is having proof for what the minimum standards (regulation and policy wise) should be
I did jury duty (though the defense was a nursing home), and understaffing was a major point of the case- pain medication inadequately given, checks for incontinence care done once a day maybe, no nurses available to assist for a patient screaming in pain, and inadequate turning. There were 3-4 CNAs for a wing of 40 patients, which gave them a bit north of 20 minutes to tend to each patient per day after removing their breaks, feeding times and meetings
