More nurses don't improve patient outcomes at safety net hospitals

While higher nurse staffing levels are often associated with improved patient outcomes, that is not the case at "safety net" hospitals that provide care to low-income, uninsured and vulnerable populations. Despite having similar staffing levels, safety net hospitals experienced worse patient outcomes than other hospitals, according to a study published in the April 2011 issue of Medical Care.

For non-safety net hospitals, more nurses were associated with fewer deaths due to congestive health failure; fewer incidents in which nurses did not note or initiate treatment in life-threatening situations (failure to rescue); lower rates of infections, including infections after operations; and shorter hospital stays. Hospitals with safety-net status saw higher rates of congestive heart failure mortality, bed sores and failure-to-rescue deaths.

But the study notes that by serving vulnerable populations, safety net hospitals tend to have poorer patient outcomes. "We suspect that the increase in mortality rates due to congestive heart failure in safety net hospitals are a function of patients' overall health, rather than staffing rates, but more research needs to be done," said the study's lead researcher, Mary Blegen, a nurse and professor at the University of California San Francisco School of Nursing.

Blegen and her team of researchers analyzed data for 1.1 million adult patients cared for in 872 units--285 of them intensive-care units --at 54 University HealthSystem Consortium hospitals, as well as the hours of care that nurses provided to those patients.

For more:
- read the article
- read the study press release