Battle on the Front Line of Patient Safety

Nearly 12,000 nurses in the Minneapolis/St. Paul area went on strike on June 10. Their chief complaint was that business decisions are adversely affecting the standards of nursing care and patient safety.

Registered nurses are on the front line for patient safety. Research proves it.

In a study released in the May/June 2010 issue of the Journal of Hospital Medicine, lead author Jeremy Sussman, MD, MS, concludes that "cuts to hospital staffing can hurt interactions between health care providers and patients, threatening robust nurse-to-patient ratios, which have been shown to affect patient safety."

A 2006 study found that hospital with high RN staffing had lower rates of five adverse patient outcomes (urinary tract infections, pneumonia, shock, upper gastrointestinal bleeding and longer hospital stays) than hospitals with low RN staffing.

Another study demonstrated that a 10 percent increase in the proportion of nurses holding a bachelor's degree was associated with a 5 percent decrease in two adverse outcomes: the likelihood of surgical patients dying within 30 days of admission and the odds of failure to rescue.

Mass layoffs of 50 or more hospital employees (with an increasing number of nurses and clinicians) reached a record high in April 2010 according to American Medical News. Nursing strikes, judicial action and lawsuits are running rampant from Pennsylvania to California. Add to this the projected nursing shortage and it's easy to imagine a serious decline in patient safety.

Dr. Sussman and his colleagues suggest that the federal government could connect hospitals' financial stability to patient safety. For example, government stimulus funds could be used to enable hospitals to employ nurse discharge advocates who could help reduce rehospitalization by providing instructions for compliance with medication doses and follow-up visits.

Government funding could also be earmarked to support nurses and clinicians by providing new technologies and methods that have been proven to reduce medical errors. According to the website Dead by Mistake, "every year approximately 200,000 American patients die preventable deaths as tools to make them safer go unused."

The number of innocent casualties is already too high for America not to take bold steps in the battle for patient safety.

— Tom DeSanto

Sources: Sussman, Halasvamani, Davis (2010),"Is the current recession compromising hospital quality?," University of Michigan, Journal of Hospital Medicine, Volume 5, Issue 5; Lovell (2006), "Solving the nursing shortage through higher wages," Washington, DC: Institute for Women's Policy Research; Aiken, Clarke, Sloane, Sochalski, Silber (2002), "Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction," JAMA, 288, 1987-1993; Image: Minneapolis Star Tribune