HealthDay News — Low levels of nurse and nursing support staffing were found to be associated with increased inpatient mortality, according to a study published in BMJ Quality & Safety.

Jack Needleman, PhD, from the Fielding School of Public Health at the University of California in Los Angeles, and colleagues examined the association of inpatient mortality with patients’ cumulative exposure to shifts with low registered nurse (RN) staffing, low nursing support staffing, and high patient turnover. The analysis included data from a three-campus US academic medical center (2007 to 2012). Low staffing was defined as staffing below 75% of annual median unit staffing for each staff category and shift type, while high patient turnover per day was defined as admissions, discharges, and transfers one standard deviation above unit annual daily averages.

The researchers found that the hazard ratio (HR) of inpatient mortality was 1.027 (95% CI, 1.002-1.053; P =.035) for exposure to shifts with low RN staffing only, 1.030 (95% CI, 1.017-1.042; P <.001) for shifts with low nursing support only, and 1.025 (95% CI, 1.008-1.043; P =.004) for shifts with both low RN and nursing support staffing. For cumulative exposure during the second to fifth days of an admission, the HR of inpatient mortality was 1.048 (95% CI, 0.998-1.100; P =.061) for exposure to shifts with low RN staffing only, 1.032 (95% CI, 1.008-1.057; P =.01) for shifts with low nursing support only, and 1.136 (95% CI, 1.089-1.185; P <.001) for shifts with both low RN and nursing support staffing. There was no association between high patient turnover and mortality.


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“The results should encourage hospital leadership to assure both adequate RN and nursing support staffing,” the authors write.

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