NSG shortage:surgical death rates rose with each patient added to nurse's workload

  1. as reported in philadelphia inquirer 10/22/02, on the front page---

    study: nursing shortage deadly
    penn researchers found surgical death rates rose with each patient added to a nurse's workload.
    by marian uhlman
    inquirer staff writer
    http://www.philly.com/mld/inquirer/4348771.htm


    full journal of american medical association(jama) article 10/23/02:

    hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction
    http://jama.ama-assn.org/issues/v288.../joc20547.html

    also covered for one minute on local news, wpvi channel 6 in philadelphia.

    p.s.: i participated in the 1999 pa survey that linda akiens performed and reports on in this article.
    Last edit by NRSKarenRN on Oct 23, '02
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  2. 14 Comments

  3. by   renerian
    You always post such interesting tidbits............I am interested in seeing if the staffing ratios in California have an effect on patient outcomes. I know it will but would like to see some statistical information in the future.

    renerian
  4. by   RN-PA
    I read this article in our local newspaper today, too, and am considering posting it in our break room. My feelings about California's nurse to patient ratios of 1:6 in Med-Surg is that it's too high. On our Med-Surg unit, the administration is justifying 1:6 ratios by citing California's recent legislation. With the acuity we're dealing with, 1:4, or at the most, 1:5 makes quite a difference in the quality of care we're able to give as well as the quality of life for nurses on the floor.
  5. by   shannonRN
    1:6 on a med-surg floor?? that is awful. hopefully, it is just a intermediate ratio until they can get the standardized ratios into effect. i don't know if they could have started off with a 1:4 ratio but i do hope that they can get there.
  6. by   oramar
    This is the first time I have read the study all the way through. I think I have been hearing about it for about two months. It is absolutely awsome. It says that in Pa alone 4 to 1 patient to nurse ratio would have reduced number of post op deaths by 1000.
  7. by   Youda
    When I read about this, the only thing that comes to my mind for the future is a scene like you'd see in an undeveloped 3rd-world culture: a huge room with patients laying all in rows, and one nurse walking among the beds knowing there is nothing more she can do but make sure each gets a little sip of water. . .
  8. by   renerian
    Wow sounds like a ward doesn't it? Used to have them when I practiced then they got rid of them thank goodness for that. I think a 1/4 would be a great ratio............sometimes when we had the floor it would 1/15 when the other nurse was doing off the floor chemo. We would pray nothing would happen.,

    renerian
  9. by   SharonH, RN
    How do you like this? Here in Atlanta, the director of nursing services at Emory Hospital refuted the study saying that most hospitals employ "as many strategies as possible" to make up for the shortage of nurses. God forbid she should use this study to get more nursing staff for her hospital.
  10. by   renerian
    The DON said that.............sheesh........


    renerian
  11. by   SandyB
    RN-PA the ratios start in July 2003 w/1:6 and then are to be changed to 1:5 at some point (don't know if it is 6mos or 1 year) and 1:6 may not be as good as we want but it is way better than what we get here in Calif now! I refuse to work med-surg with ratios 1:12 and I sure hope if I get sick before July2003 that all my friends who are nurses take turns watching out for me!
  12. by   pickledpepperRN
    From the DHS web site:

    [ "CDHS's policy decisions were found to remediate the hospitals with the leanest staffing, effectively raising the bar for the standard of acceptable staffing. "

    "The establishment of minimum nurse-to-patient ratios will set the baseline licensed staffing requirement for every unit type. The proposed minimum ratios will increase the number of licensed nurses on the 5-25% of hospital shifts with the leanest staffing statewide as soon as the regulations go into effect. Twelve months later, when the general medical/surgical units change to a minimum of 1:5, the proposed ratios will have the effect of increasing licensed nurse staffing for more than 50% of the leaner-staffed shifts in those units. The PCS will remain in place to indicate the needed increases beyond minimum licensed staffing as patient acuity increases."

    PCS = Patient Classification System
    Last edit by pickledpepperRN on Oct 24, '02
  13. by   pickledpepperRN
    [url]http://www.applications.dhs.ca.gov/regulations/store/Regulations/R-37-01%20ISOR%20SOD.doc

    Sorry, this link does not work. I am not able to delete it.
    Last edit by pickledpepperRN on Oct 24, '02
  14. by   RN-PA
    Originally posted by shannonRN
    1:6 on a med-surg floor?? that is awful. hopefully, it is just a intermediate ratio until they can get the standardized ratios into effect. i don't know if they could have started off with a 1:4 ratio but i do hope that they can get there.
    The 1:6 ratio is for the 3-11 shift I work. On 11-7, they've often had to work 1:12 because we can't keep new hires on the floor for long-- they either quit or transfer to other units, and Agency nurses refuse to work our Med/Surg-- so they are consistently short-staffed. On my shift, if I have to "cover" an LPN's patients as well, I can be dealing with a total of 12 charts and potential patient problems some evenings, too.

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