From the Massachusetts Nurse Newsletter
March 2005 Edition
Poor RN staffing has been identified as "one of the major factors expected to constrain hospitals’ ability to deal with future outbreaks of emerging infections." This was the conclusion reached by four nursing researchers who summarized 16 disease outbreaks, prospective and retrospective studies of healthcare associated infections in a recent report for CDC (Centers for Disease Control) in their November 2004 report.
The 16 studies cited found, for example:
- BSI (blood stream infection) was associated with lower regular RN-patient and higher pooled staff-patient ratios in a 20 bed surgical unit
- Increased RN hours per adjusted patient day was associated with decreased incidence of pneumonia in a study of 530 hospitals in 10 states
- A higher proportion of RN hours resulted in decreased UTI in a study of over 6 million patients in 799 hospitals
- MRSA cases (a potentially deadly antibiotic-resistant staph infection) were associated with a decrease in RN-topatient ratio in a study of 50 patients in an adult unit
The cost of treating these types of infections is enormous. One study in the Journal of the American Medical Association found the cost of treating sepsis, a severe complication that develops from these infections, to be in excess of $57,000 per incident added to a patient’s hospital bill.
Another study in the New England Journal of Medicine found that improvements in RN staffing and better RN-to-patient ratios can decrease incidence of sepsis by 6 percent, which translates into millions of dollars in annual savings to hospitals, not to mention thousands of lives.
Previous warnings from CDC
As the toll of complications and harm to patients continues to mount in our hospitals, it is important to note they have been given warnings for years to address these conditions.
As early as 1997, the CDC had issued an advisory to all hospitals in the country of the dangers of poor staffing in ICUs, as well as the use of temporary/agency RNs, citing a rise in preventable infections to patients. The evidence is clear. The industry has not and will not provide appropriate RN staffing on its own. The time has come to pass the patient safety/safe RN staffing bill.
