May 5, 2000 -- As more and more hospitals try to cut costs by trimming theirstaffs, a new study suggests that registered nurses (RNs) should be some of thelast staffers to go -- because patients fare better in hospitals with moreRNs.
In the study, researchers found that patients treated in hospitals withgreater numbers of registered nurses had shorter hospital stays, fewer cases ofhospital-acquired pneumonia and fewer post-surgery infections, bed sores, andurinary tract infections than patients at hospitals with fewer RNs.
"Shorter lengths of stay and fewer complications translate into lowerhospital costs," writes Mary Foley, MS, RN, in a research announcement.Foley is the president of the American Nurses Association (ANA), which releasedthe study's results at the Nurse Staffing Summit, held in Washington, D.C., onMonday and Tuesday.
"Not only do patients fare better," Foley writes, "but hospitalscan actually save money by using highly skilled nurses in adequatenumbers." The new findings come at a time when many hospitals areexperiencing a shortage of nurses.
"It makes no sense for hospitals to cut RN staff or replace RNs withunlicensed assistive personnel who lack the education and judgment of RNs,"she says. "For years, hospitals have tried to cut corners in this way butthe data keep disproving this approach."
Now RNs have the data to support their value to hospital patients, shesays.
To arrive at the findings, the researchers from Network Inc., a hospital andhealth care research organization, reviewed hospital and insurance data fromnine states. Overall, patients in hospitals with more nurses had fewercomplications than patients who received their care in hospitals with fewer RNson staff, the study showed.
Few RNs are surprised by the new findings.
"Nursing care is critical to patients in the hospital," ChristineKovner, RN, PhD, a professor in the division of nursing at New York Universityin New York City, tells WebMD. "Nurses are the people that are there 24hours a day monitoring patients and assessing what is going on with thepatients."
For example, if a nurse is there to monitor a patient after surgery, he orshe can catch any early warning signs of pneumonia by monitoring the patient'sbreathing and the sounds in his or her chest.
"The No. 1 reason we need more nurses is that patients who are monitoredcarefully will likely do [better] than patients who aren't," she tellsWebMD.
A nurse's primary responsibilities are to dispense medications and handleany emergencies, Kovner says. But when there are not enough nurses on staff,the ones present don't have the time to do monitoring to prevent complications,she says.
"We are concerned about the status of patients who need care andmonitoring and that care not being available," says Sally Raphel, MSN, RN,director of nursing practice and quality initiative at the ANA.
Nurses also work with patient's families and educate them about the illnessand treatment, Raphel tells WebMD. "Nurses are valued by patients."
"We can now show that patient outcomes are directly correlated withstaffing mix," Raphel says. "We are very pleased with theresults."
Kimberly Lisa Fiedelman, a nursing student at Fiorella LaGuardia School ofNursing in Queens, N.Y., tells WebMD that she is concerned that good nursingjobs may not be plentiful when she completes her schooling.
"I'm glad that this and other studies are helping to better define anddelineate the value of nurses in hospitals," she says.
- At a recent conference, The American Nurses Association released a studythat found patients have better results at hospitals that employ the mostregistered nurses.
- Nurses say they add a level of monitoring to care that is not present whenhospitals stretch their nursing staff too thinly.
- The nurses say the study indicates cutting nursing staff doesn't savehospitals money, but could result in making care more expensive if patients goon to suffer further illness that nurses could help prevent.