A handful of studies released in the last year regarding nurses demonstrate the important role nurses play in quality of care and healthcare delivery.
The studies revealed that nurse understaffing and fatigue negatively impact the quality of care delivery, patient and employee satisfaction and operational costs in hospitals.
One of the studies, released last winter, also found that increased nurse-to-patient staffing ratios and good work environments for nurses were tied to lower 30-day readmission rates for Medicare patients suffering from heart failure, myocardial infarction and pneumonia.
According to Matthew McHugh, study leader and assistant professor at the University of Pennsylvania School of Nursing, the Robert Wood Johnson Foundation study revealed that, even after accounting for patient and hospital characteristics, nurse staffing levels and nurses’ work environment had a significant impact on readmissions for heart failure, myocardial infarction and pneumonia patients.
“Our findings indicate that improving nurses’ work environments and reducing their workloads can reduce readmissions for Medicare patients with common conditions,” said McHugh. “If it’s a good place for a nurse to work, he or she is able to do the things that help prevent readmissions. It’s important to have good relationships with colleagues and physicians, and support by managers. This is one thing hospitals know they can do to keep patients out of the hospital. Regardless of what the outcome is, patients are better off in hospitals where nurses are happier doing their job.”
According to the study, each additional patient per nurse in an average nurse’s workload was associated with a 7 percent, 6 percent and 9 percent higher odds of readmission for heart failure patients, pneumonia patients, and myocardial infarction patients, respectively, within 30 days of being discharged. Care in hospitals with good versus poor work environments for nurses was associated with 7 percent, 6 percent and 10 percent lower odds of 30-day readmission for heart failure patients, myocardial infarction patients, and pneumonia patients, respectively.
An issue that goes hand-in-hand with understaffing is nurse fatigue. Not enough hands to do the work means more burden and more fatigue on those on staff.
A study released last spring by Kronos,“Nursing Staffing Strategy,” found that 69 percent of healthcare professionals surveyed said that fatigue had caused them to feel concern over their ability to perform during work hours. Additionally, nearly 65 percent of participants reported they had almost made an error at work because of fatigue and more than 27 percent acknowledged that they had actually made an error resulting from fatigue.
Susan Reese, the director of the healthcare practice group at Kronos, said the aging nurse population and nurses working shifts that are longer than eight hours are partially to blame for the high fatigue levels among nurses.
“In 2008, the average age of nurses was 45.5. It’s probably closer to age 50 now. One of the areas we consider is that the aging workforce gets fatigued easier. These highly-skilled workers have to make critical decisions related to patient care and if they are doing that in a fatigued state, they are putting themselves and their patients at a great risk for errors and injuries,” said Reese. “There is research that says every hour that a nurse works over 40 hours puts them at a greater risk for fatigue.”