Death Risk of Surgical Patients Linked to Nurses' Caseload

A study of 168 hospitals in Pennsylvania has found that for each additional patient over four in a registered nurse's workload, the risk of the death increases by 7% for surgical patients. This means that patients in hospitals with the lowest nurse-staffing levels (eight patients per nurse) have a 31% greater risk of dying than those in hospitals with four patients per nurse. The findings were published in the October 23, 2002, issue of The Journal of the American Medical Association.

On a US national scale, staffing differences of this magnitude could result in as many as 20,000 unnecessary deaths annually. Another finding indicated that each additional patient per nurse is related to a 23% increased risk of nurse burnout and a 15% increased risk of job dissatisfaction. Of nurses with high burnout and dissatisfaction, 43% intend to leave their jobs within the next year, compared to only 11% who plan to leave and do not have burnout and dissatisfaction. This finding is related to increasing hospital costs. The cost of replacing a hospital specialty nurse is estimated at US$64,000. Satisfactory nurse staffing levels can save money as well as lives and help retain staff.

According to principal investigator Linda Aiken, Ph.D, R.N., "Clearly, there is a direct relationship between nurse staffing and patient well being. Nurse staffing is an issue that needs priority attention on a national scale. Patients' lives depend on it.” Dr. Aiken is the Director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing (Philadelphia, USA; www.upenn.edu).

The study data, from 1998 and 1999, included 10,000 nurses and more than 232,000 surgical patients with common surgeries, such as appendectomies and orthopedic and vascular surgeries.




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