[pickledpepperRN]

Hazards: Lower Nurse-to-Patient Ratio Is Linked to Pneumonia Risk

The fewer nurses there are on duty in an intensive care unit, the more people on respirators get pneumonia, a new study has found…

http://www.nytimes.com/2007/07/24/he...tml?ref=policy

Provisional PDF of article: http://ccforum.com/content/pdf/cc5974.pdf


Abstract: Staffing Level: A Determinant of Late-Onset Ventilator-Associated Pneumonia

[wjf00]

File one under "Well Duh" But as we strive for 'evidence based practice', it is nice to have a study to highlight the obvious.

[BBFRN]

There is a 2004 American study (M.W. Stanton, Research In Action) that shows hospital acquired pneumonia (as well as C-Diff, MRSA, med errors, shock, GIB, decubs, & physical injury) rates are directly correlated to nurse-to-patient ratios. Treating hospital-acquired pneumonia alone can cost over $28,000, and add many days to a patient's length of stay.

Yet, some hospitals continue to engage in bare-bones staffing. I wrote a research paper regarding this, and how hospitals could actually save money by staffing appropriately, because preventing these things are cost effective. As it stands, many facilities are placing quality of care issues on the backs of nurses without addressing the ratios, and taking some responsibility themselves.

[lindarn]

Originally Posted by Baptized_By_Fire

There is a 2004 American study (M.W. Stanton, Research In Action) that shows hospital acquired pneumonia (as well as C-Diff, MRSA, med errors, shock, GIB, decubs, & physical injury) rates are directly correlated to nurse-to-patient ratios. Treating hospital-acquired pneumonia alone can cost over $28,000, and add many days to a patient's length of stay.

Yet, some hospitals continue to engage in bare-bones staffing. I wrote a research paper regarding this, and how hospitals could actually save money by staffing appropriately, because preventing these things are cost effective. As it stands, many facilities are placing quality of care issues on the backs of nurses without addressing the ratios, and taking some responsibility themselves.

The reason that most hospitals engage in this behavior, is because, to do otherwise, they would have to acknowledge that nursing care actually adds worth to our practice. That would mean that nurses would realize their worth and ask for more money. Follow the money trail!

Lindarn, RN, BSN, CCRN
Spokane, Washington

[BBFRN]

Or it could be that they are constantly playing catch-up with their budgets, and nursing is the "cost factor" that is most easily manipulated.

[HM2Viking]

This is in the no kidding category. Thanks for putting this up Space!

[NRSKarenRN]

Same the world over...

...One reason for increased infections, said Dr. Stéphane Hugonnet, the lead author of the study and an epidemiologist at the University of Geneva Hospitals, is that “nurses have too much work to do and don’t comply with basic hygiene rules.”

“But,” he added, “there have been good studies that find a close relationship between work load, job satisfaction, intention to leave and burnout — and all of these were related to increased infection as well.”

[BBFRN]

Yes- Linda Aiken did that study called Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction (JAMA 2002). This article is a must-read for every nurse- especially those working in med/surg.

Here is a link to reviews, abstract, etc: http://www.nursingadvocacy.org/news/2002oct23_jama.html

"In a large research study entitled Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction published in the Journal of the American Medical Association, University of Pennsylvania nursing scholar Linda Aiken and her colleagues found that: Each additional patient assigned to a nurse resulted in a:

• 30-day patient mortality increases by 7%,
• failure-to rescue rates increase by 7%,
• the odds of nursing job dissatisfaction increase by 15% and
• the odds of nurse burnout increase by 23%.

When nurses had eight patients instead of four, their patients had a 31% higher chance of dying within 30 days of admission.
Forty-three percent of the nurses surveyed were burned out and emotionally exhausted. Nurses who were burned out were 4 times as likely to report that they were leaving their jobs in the next year."



This study was used as one of the rationales for the CA ratio law.

[TrudyRN]

Originally Posted by Baptized_By_Fire

Or it could be that they are constantly playing catch-up with their budgets, and nursing is the "cost factor" that is most easily manipulated.

Or they'd rather give their bigwigs Christmas bonuses than pay their nurses what they're worth. : devil:

[Haunted]

This reminds me of a facility I worked at thru my registry in So Cal who shall remain nameless (but their initials are Kaiser Permenente) who , when I notified the charge nurse that I had defective patient beds that would not raise the HOB up for my tube feed patients, I was told "It's cheaper to treat them for aspiration PNA then replace the beds!" A course of antibiotics would cost the hospital less in the long run then a 12 thousand dollar bed that worked properly.