Nursing workloads multiply likelihood of death among black patients over white patients

October 16, 2012

Older black patients are three times more likely than older white patients to suffer poorer outcomes after surgery, including death, when cared for by nurses with higher workloads, reports research from the University of Pennsylvania School of Nursing. The large-scale study showed higher nurse workloads negatively affected older surgical patients generally and that the rate was more significant in older black individuals. When the patient-to-nurse ratio increased above 5:1, the odds of patient death increased by 3 percent per additional patient among whites and by 10 percent per additional patient among blacks.

Lead author J. Margo Brooks Carthon, PhD, RN, and Penn Nursing colleagues studied more than 548,000 patients ages 65 and older undergoing general, orthopedic, or vascular surgery in 599 hospitals in California, Florida, New Jersey, and Pennsylvania. These hospitals are among the largest in the country and account for more than one-fifth of the nation's hospitalizations.

"Hospitalized sometimes experience periods of instability in vital functions, and the quality of nursing care they receive has a significant effect on their recovery and well-being," said Dr. Carthon. "This is particularly relevant to older black patients because of associated complex medical conditions that may compromise their health status postoperatively."

In the study, 94 percent of patients were white and 6 percent were black. Data were comprised from nearly 30,000 nurses working directly in patient care. The study assessed mortality and failure to rescue, which was defined as death after the development of a complication in the hospital after surgery.

The correlation between and in the U.S. and around the world has been long established, largely by the pioneering work of study co-author Linda H. Aiken, PhD, RN, who directs the Penn Nursing Center for and Policy Research. And, while are widely documented in the health sciences literature, how the quality of nursing care may affect minority patient outcomes is a new area of research.

In this study, the data suggest that the probability of death for black patients is equal to that of white patients when the patient-to-nurse ratio is low to average (considered up to 5:1). The finding that the odds of death for older black patients were greater in hospitals where nurses had heavier has particular implications for the delivery of care and signals an important focus of future research and intervention, Dr. Carthon wrote.

"These results suggest that improving the quality of postsurgical outcomes of older patients, particularly older black patients, means putting more nurses on the floor," said Dr. Carthon. "Better staffed hospitals are better prepared to meet the more complex needs of older patients, particularly minorities with higher rates of co-existing conditions."

Explore further: International research finds quality and safety problems in hospitals throughout 13 countries

Related Stories

To keep nurses, improve their work environments

December 8, 2011

Nurses working in hospitals around the world are reporting they are burned out and dissatisfied with their jobs, reported researchers at the University of Pennsylvania School of Nursing's Center for Health Outcomes and Policy ...

Better together - The RN and the EHR

January 17, 2012

With the prodding of new federal legislation, electronic health records (EHRs) are rapidly becoming part of the daily practice of hospital nurses – the frontline providers of care. In the first large study of its kind, ...

California nurse staffing

July 15, 2011

In a comprehensive analysis comparing nurse staffing in California hospitals to similar hospitals in the U.S. over nearly a decade, researchers at the University of Pennsylvania School of Nursing have found that controversial ...

Recommended for you

Recommended daily protein intake too low for the elderly

May 23, 2017

You can find the recommended dietary allowance (RDA) on the nutrition labels of all your processed food. Food manufacturers are obliged to list the nutritional value of their products, and therefore must mention the percent ...

Faster is better when it comes to sepsis care

May 22, 2017

Following the tragic and widely publicized death of Rory Staunton, 12, from undiagnosed sepsis in 2012, New York became the first state to require that hospitals follow a protocol to quickly identify and treat the condition.

Moderate drinking may not ward off heart disease

May 22, 2017

Many people believe that having a glass of wine with dinner—or moderately drinking any kind of alcohol—will protect them from heart disease. But a hard look at the evidence finds little support for that.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.