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Lower surgical mortality in hospitals with ‘best nursing care’

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Hospitals with better nurse staffing levels are associated with lower mortality after surgery, especially for higher risk patients, according to US researchers.

Patients undergoing general procedures at hospitals with “better nursing environments generally receive care of higher value”, said the study authors in the journal JAMA Surgery.

“Better nurse staffing throughout the hospital does not have to be more costly”

Linda Aiken

The study focused on so-called Magnet hospitals, which are accredited under a scheme started in the US that recognises nursing excellence and good nurse staffing.

The Magnet scheme assesses the quality of nursing care within healthcare organisations. At present, only around 6% of hospitals in the US have achieved Magnet status, which is granted by the American Nurses’ Credentialing Center, an affiliate of the American Nurses Association.

The study authors compared matched pairs of patients having surgery in 328 hospitals. Pairs had the exact same surgical procedure and were very similar in terms of age, sex, severity of illness, demographics, and chronic illnesses.

The analysis focused on 25,752 closely matched pairs of patients, of which one in each pair was cared for in a Magnet hospital. They were selected from a total pool of 88,634 Medicare patients.

The 35 Magnet hospitals had a mean nurse-to-bed ratio of 1.51, while 293 control hospitals had a mean nurse-to-bed ratio 0.69.

“Patients undergoing general surgery at hospitals with better nursing environments generally receive care of higher value”

Study authors

The researchers, from the University of Pennsylvania School of Nursing, found 30-day mortality in Magnet hospitals was 4.8% versus 5.8% in control hospitals.

The outcomes advantage for patients in Magnet hospitals was greater for all patients, but especially for sicker and more complicated patients, noted the study authors.

They said: “Hospitals with better nursing environments and above-average staffing levels were associated with better value – lower mortality with similar costs – compared with hospitals without nursing environment recognition and with below-average staffing, especially for higher-risk patients.

Professor Linda Aiken

Professor Linda Aiken

Source: Professor Linda Aiken

Linda Aiken

“These results do not suggest that improving any specific hospital’s nursing environment will necessarily improve its value, but they do show that patients undergoing general surgery at hospitals with better nursing environments generally receive care of higher value,” they said.

Professor Linda Aiken, director of the Center for Health Outcomes and Policy Research at the Pennsylvania University’s school of nursing, added: “A surprising finding was that better nurse staffing throughout the hospital does not have to be more costly.

“Indeed, we found that Magnet hospitals achieved lower mortality at the same or lower costs by admitting 40% fewer patients to intensive care units and shortening length of hospital stay,” she said in a statement.

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Readers' comments (1)

  • You don't say........................!! I wonder how much it cost to reach this (very obvious) conclusion!

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