Satisfied nurses improve hospital outcomes, mortality
Nurses have a significant impact on the success of a hospital, according to a study of a team of Kaiser Permanente nurses published in Health Care Management Review.
Many hospitals have tried and failed to replicate the Kaiser model, currently present in eight states, which integrates hospitals, insurance and doctors' offices into one system, researchers said. The problem may be that hospitals have overlooked the level of nurse satisfaction and happiness, and how much they are willing to invest in it, the new study found.
"It turns out that, by and large, nursing differences accounted for much of the mortality difference that we saw in Kaiser Permanente hospitals," lead author Matthew McHugh, R.N., Ph.D, a professor at the University of Pennsylvania's School of Nursing, told Yahoo.
A cross-sectional analysis with data from various sources, including the survey results for nurses at 564 adult, general acute care hospitals in California, Florida, Pennsylvania and New Jersey allowed the researchers to examine whether patient and nurse outcomes were better in Kaiser hospitals. Researchers questioned nurses about their work environment, level of education, job satisfaction and typical number of patients seen each day. In addition, the researchers referenced mortality data for each hospital.
The research team also analyzed whether a hospital with Magnet status, "a proven and cost-effective strategy to improve process of care through investments in nursing," favorably compared to Kaiser hospitals. Out of the 564 hospitals, 25 were Kaiser Permanente hospitals and 56 were Magnet hospitals. Not only did the Kaiser and Magnet status hospitals achieve comparable outcomes, they presented significantly better patient and nurse outcomes than their opponents, the study found. Mortality rates were 20 percent lower in Kaiser and Magnet hospitals. The study attributed "a sizable portion of the advantage" to the nursing staff.
"We wanted to make sure that we were a place that nurses wanted to work," Marilyn Chow, R.N., vice president of Patient Care Services and Innovation for Kaiser Permanente, told Medical Daily.
Kaiser Permanente hospitals also had better nurse work environments and staffing levels, as well as more nurses with bachelor's degrees compared with their opponents, according to the study. Several factors accounted for this result, according to McHugh and his team, including the fact that hospitals empowered nurses by giving them the opportunity to make more decisions; the hospitals' willingness to make tangible changes to make it easier for nurses to do their jobs; and having four patients for every nurse, as opposed to the typical five-to-one ratio.
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