The number and mix of nurses in a hospital makes a difference in the quality of care patients receive, according to a Department of Health and Human Services study released today. 

The study, Nurse Staffing and Patient Outcomes in Hospitals, is based on 1997 data from more than five million patient discharges from 799 hospitals in 11 states.  It found a strong and consistent relationship between nurse staffing and five outcomes in medical patients -- urinary tract infection, pneumonia, shock, upper gastrointestinal bleeding, and length-of-stay.  A higher number of registered nurses was associated with a 3 percent to 12 percent reduction in the rates of adverse outcomes, while higher staffing levels for all types of nurses was associated with a decrease in adverse outcomes from 2 percent to 25 percent.

“This study underscores why the Bush Administration budget increases funding for nurse training programs,” said HHS Secretary Tommy G. Thompson.  “We have to take action to address the emerging nurse shortage to protect the health and well-being of all patients.”

According to the study, the costs associated with patient complications can be substantial. Reductions in the rates of adverse outcomes reduce hospital costs as well as significant financial and psychological costs to patients and their families.

“Hospitals can use these findings to improve quality and performance measures across the board to ensure better nursing care for all patients,” said Sam Shekar. M.D., M.P.H., HRSA’s associate administrator for health professions. 

“We need to know more not only about how nurse staffing affects quality, but also about the working conditions in which nurses provide care,” said John M. Eisenberg, M.D., director of the Agency for Healthcare Research and Quality (AHRQ). “Excellent nurses may have difficulty providing excellent care if they are working in conditions that are not conducive to quality care.”

HHS funded this study as a result of a series of activities stemming from a 1993 congressional hearing that focused national attention on the delivery of nursing care in hospitals and its effect on patient care.  Subsequently, the Institute of Medicine examined the same issues and concluded that more research was needed on the relationship between quality of patient care in hospitals and the level and mix of nurse staffing. Four HHS agencies—the Health Resources and Services Administration, Health Care Financing Administration, Agency for Healthcare Research and Quality, and the National Institute of Nursing Research of the National Institutes of Health – sponsored the study. It was conducted by the Harvard University School of Public Health.

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