A shortage of registered nurses
may leave patients in hospitals exposed to more complications, a
new study in the New England Journal of Medicine suggests.
Researchers evaluated medical records from 799 hospitals in
1997, accounting for about a quarter of all discharged patients in
the U.S. during the year. Care from registered nurses proved
critical in preventing eight of 25 problems, including urinary
tract infections and extended hospital stays, they found.
“Our findings clarify the relation between the levels of
staffing by nurses and the quality of care,” said the
researchers, who were led by Jack Needleman from the Harvard
School of Public Health. “We found consistent evidence of an
association between higher levels of staffing by registered nurses
and lower rates of adverse outcomes.”
The finding may exacerbate worry about the growing shortage
of registered nurses. While the U.S. has more than 2.5 million
registered nurses, many leave the profession saying they are
overworked, underpaid, and unable to provide good patient care,
the journal’s Robert Steinbrook wrote in a health policy report.
The effects of care from registered nurses was greater for
patients treated with medicines than for those undergoing surgery,
the study found. Surgical patients may be healthier when they
enter the hospital, and therefore less susceptible to
complications during their stay, researchers said.
Other Complications
In medical patients, higher levels of staffing with
registered nurses also influenced rates of internal bleeding,
hospital-acquired pneumonia, shock or cardiac arrest, and, to a
lesser extent, death from a combination of five causes. Only
urinary infections and deaths, to a limited extent, were
influenced among surgery patients.
“Hospital administrators, accrediting agencies, insurers,
and regulators should take action to ensure that an adequate
nursing staff is available to protect patients and to improve the
quality of care,” the researchers concluded.
Hospitals began experiencing a shortage of nurses in 1998,
and about 13 percent of all registered nursing positions went
unfilled in 2001, according to the American Hospital Association.
Salaries for registered nurses have been little changed in recent
years, with annual full-time pay averaging about $47,000,
according to the Health Resources and Service Administration.
“As the population ages, the demand for nurses is expected
to grow rapidly,” Steinbrook wrote. “The future of the nursing
profession is related to its ability to attract more young nurses,
to support the careers of current nurses, and to create more jobs
for nurses with higher wages and greater responsibilities.”
Bloomberg News
