Greater nurse staffing tied to better sepsis outcomes

Hospitals that provide more registered nurse hours of care could likely improve outcomes for Medicare beneficiaries with sepsis, according to a study published online May 27 in JAMA Health Forum.

Jeannie P. Cimiotti, Ph.D., from Emory University in Atlanta, and colleagues assessed whether registered nurse workload was associated with mortality in Medicare beneficiaries admitted to an acute care hospital with sepsis. Analysis included 2018 data from the American Hospital Association Annual Survey, CMS Hospital Compare, and Medicare claims on Medicare beneficiaries.

The researchers identified 702,140 Medicare beneficiaries (mean age, 78.2 years; 51 percent women) with a diagnosis of sepsis. The mean Severe Sepsis and Septic Shock Management Bundle (SEP-1) score was 56.1, and registered nurse hours per patient day (HPPD) was 6.2. Each additional registered nurse HPPD was associated with a 3 percent decrease in the odds of 60-day mortality (odds ratio, 0.97) when adjusting for SEP-1 score and hospital and patient characteristics.

"As we redefine the sepsis bundle, it is imperative that we include the workload of nurses and other clinicians and promote a care environment that fosters interprofessional communication," the authors write. "Not doing so will place patients at increased risk of sepsis-related mortality and nonmortality adverse events."

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