Study: RNs Save More Lives

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Study: RNs Save More Lives

Wed May 29, 5:00 PM ET

By JEFF DONN, Associated Press Writer

Hospitals staffed with more registered nurses ‹ the most highly skilled kind

‹ save more lives from deadly complications, researchers say in a study that

is likely to intensify worries about the nation's growing nursing shortage.

" Will we see more of these adverse outcomes because we don't have the

knowledge of the registered nurses in the clinical setting? " asked

Rowell, a research analyst at the American Nurses Association.

The researchers, whose findings were published in Thursday's New England

Journal of Medicine (news - web sites), analyzed 6.2 million patients

released from 799 hospitals in 11 states in 1997. The patients accounted for

about a quarter of those who were discharged nationwide.

The researchers at Harvard and Vanderbilt universities compared the 25

percent of general medical and surgical patients who got the most nursing

care with the 25 percent who got the least. They broke down the nursing care

by the number of hours and the amount provided by registered nurses,

licensed practical nurses, and nursing aides.

RNs have college degrees in nursing and are often allowed to develop nursing

plans and coordinate care by therapists and other specialists. Licensed

practical nurses generally have a year of formal training but no degree.

Nursing aides often have minimal training.

In some of the most striking findings, medical patients with the greatest

proportion of RN care ‹ relative to LPNs and aides ‹ were 9 percent less

likely to suffer shock or cardiac arrest, or to get a urinary tract

infection. Medical patients with more hours of RN care also spent 5 percent

less time in the hospital.

Surgical patients with more hours of RN care were 6 percent less likely to

die from pneumonia, shock or cardiac arrest, upper gastrointestinal

bleeding, blood poisoning, or clotting.

However, the researchers found no health benefit from more care by either

LPNs or aides. That finding brings into question the cost-cutting practice

at some hospitals of replacing RNs with less skilled nursing staff.

" There's a tremendous amount of judgment and understanding of the courses of

illness that RNs bring to the bedside, " said Jack Needleman, the Harvard

health policy researcher who led the study. " It's not just a matter of

having more bodies. "

He said hundreds of patients ‹ possibly thousands ‹ die each year from lack

of advanced nursing care.

The average vacancy rate for RN jobs is 13 percent, according to a report

commissioned by the American Hospital Association. And many expect the

shortage to grow with the aging of the nursing work force and the general

population.

The Harvard study, which was funded by the government, is meant to give

direction to policy makers on medical costs and nurse staffing.

" We know we're about to enter a nursing shortage that we've never had

before, " said Pamela , a registered nurse who leads the American

Organization of Nurse Executives. " What this study shows is yet again a

piece of evidence that we need to be doing everything we can to make sure we

have the nursing staff that we need in the next five to 10 years. "