Cutting Proportion of RNs on Care Teams Tied to Worse Outcomes

THURSDAY, Aug. 29, 2024 (HealthDay News) — Reducing the proportion of registered nurses (RNs) in hospitals, even when total nursing personnel hours are kept the same, is likely to result in significantly worse outcomes, according to a study published in the July issue of Medical Care.

Karen B. Lasater, Ph.D., R.N., from the School of Nursing at the University of Pennsylvania in Philadelphia, and colleagues evaluated whether reducing the proportion of RNs to total nursing staff in hospitals is in the best interest of patients, hospitals, and payers. The analysis included data from 6.6 million Medicare patients seen in 2,676 general acute care U.S. hospitals in 2019.

The researchers found that a 10 percentage-point reduction in RNs was associated with 7 percent higher odds of in-hospital death, 1 percent higher odds of readmission, a 2 percent increase in expected days, and lower patient satisfaction. An estimated 10,947 avoidable deaths annually and 5,207 avoidable readmissions would result from a 10 percentage-point reduction in RNs, translating to roughly $68.5 million in additional Medicare costs. Furthermore, because of patients requiring longer stays, hospitals would forgo nearly $3 billion in cost savings annually.

“Estimates represent only a 10 percentage-point dilution in skill mix; however, the team nursing model includes much larger reductions of 40 to 50 percentage-points — the human and economic consequences of which could be substantial,” the authors write.

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