RN staffing affects patient success after discharge
Higher non-overtime staffing levels of registered nurses lower the probability of patient readmissions to the hospital, a new study finds. However, higher levels of RN overtime increase the likelihood of unplanned visits to emergency departments after discharge.
The study clearly documents for nurse managers and hospital administrators that staffing decisions have consequences for patient outcomes, said study author Marianne Weiss, an associate professor at Marquette University College of Nursing. RN staffing affects the quality of discharge teaching provided to patients, which in turn affects how ready patient feel to go home from the hospital and impacts readmission and ED visit rates in the first 30 days after discharge.
The researchers looked at 1,892 medical/surgical patients in 16 nursing units of four acute-care hospitals in 2008. When the units had higher RN non-overtime staffing levels, readmission to hospital was 44 percent lower for each extra 45 minutes of nursing care per patient per day. When RN overtime was lower, so too were the number of ED visits after discharge.
The authors attribute this in part to nurses teaching patients how to manage their condition after discharge and to the skill of the nurses as teachers. Patients reported higher satisfaction rates with the quality and content of this teaching when RN staffing was higher, and said they felt well prepared and ready for discharge.
In contrast, the stress and fatigue of working overtime can affect the quality of this teaching negatively, leading to poorer discharge outcomes and higher ED visits, according to the study appearing online in the journal Health Services Research.
According to the authors, this study also implies that health care costs could be lower in the long run − but not under current payment systems. They project that if the 16 nursing units studied implemented the 45-minute increase in non-overtime nursing care, they could save more $11 million annually from reduced readmissions and another $500,000 annually with the decrease in overtime.
Preventable readmissions and emergency room use following hospitalization are concerning sources of unnecessary costs, said Matthew McHugh, Ph.D., at the Center for Health Outcomes and Policy Research of Pennsylvania School of Nursing.
Although programs for intensively managing patients as they transition from the hospital to home are vital, the availability and funding for such services is limited, McHugh said. On the other hand, virtually all patients receive bedside nursing care during hospitalization. Sufficient levels of these vital nursing resources are necessary to ensure not just good outcomes in the hospital but after patients leave. The authors cost analysis further supports the business case for sufficient, high-quality nurses as a good investment for hospitals and patients.
More information: Weiss ME, Yakusheva O, Bobay KL. Quality and cost analysis of nurse staffing, discharge preparation, and postdischarge utilization. Health Services Research online, 2011.
Provided by Health Behavior News Service
- Hospital nurses dissatisfied with health benefits Feb 14, 2011 | not rated yet | 0
- UF study: Florida nurses below U.S. average for higher degrees; patient care may suffer Feb 24, 2011 | not rated yet | 0
- Risk of hospital patient mortality increases with nurse staffing shortfalls, study finds Mar 17, 2011 | not rated yet | 0
- New tool to predict early death or hospital readmission Mar 01, 2010 | not rated yet | 0
- Researchers study program to help older adults transition from hospital to home Jul 28, 2009 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
(HealthDay)—Each summer, lawn mower accidents send countless numbers of people to the emergency room. Mishaps often involve serious injuries to the fingers, hands and feet. Often caused by a moment's distraction, ...
Health 8 hours ago | not rated yet | 0
(HealthDay)—Animals make great companions for senior citizens, but elderly people who always drive with a pet in the car are far more likely to crash than those who never drive with a pet, researchers have ...
Health May 25, 2013 | not rated yet | 1
Talking on a hands-free device while behind the wheel can lead to a sharp increase in errors that could imperil other drivers on the road, according to new research from the University of Alberta.
Health May 24, 2013 | not rated yet | 1
(HealthDay)—More than one in four of those eligible for new premium assistance tax credits under the Affordable Care Act (ACA) do not have a checking account and will not be able to receive premiums from ...
Health May 24, 2013 | not rated yet | 0
After studying noise in one French Quarter neighborhood of New Orleans to determine whether or not noise levels exceeded municipal ordinances, Annette Hurley, PhD, Assistant Professor of Audiology at LSU Health Sciences Center ...
Health May 24, 2013 | not rated yet | 0
Neuroscientists from Cold Spring Harbor Laboratory, led by Assistant Professor Adam Kepecs, have linked the activity of two types of brain nerve cells, neurons, to decisions made during particular type of ...
9 hours ago | 5 / 5 (2) | 0 |
Researchers at the Stanford University School of Medicine have identified mutations in several new genes that might be associated with the development of spontaneously occurring cases of the neurodegenerative disease known ...
9 hours ago | 5 / 5 (1) | 0 |
Humans and most mammals can determine the spatial origin of sounds with remarkable acuity. We use this ability all the time—crossing the street; locating an invisible ringing cell phone in a cluttered bedroom. ...
9 hours ago | 5 / 5 (1) | 0 |
A new way of tackling cancer and predicting tumor virulence are has been reported by a French team of scientists from the Institut Albert Bonniot de Grenoble including researchers from CNRS, Inserm and Université Joseph ...
5 hours ago | 5 / 5 (1) | 0
An 81-year-old woman who had contracted a SARS-like coronavirus has died in Saudi Arabia, raising the death toll in the kingdom to 18, the health ministry said in a statement on Sunday.
9 hours ago | not rated yet | 0
(HealthDay)—Memorial Day weekend is the unofficial start of summer, and experts note that you need to protect your skin while spending time in the sun.
9 hours ago | 5 / 5 (1) | 0