Better Working Environment for Nurses can Reduce Death Rates in Hospital: Study

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Apart from having high-quality facilities and equipment, a good hospital has always been associated with having the best doctors. But, according to a new study, hospitals with better nursing environments can also make a difference.

"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," the authors of the study wrote in their findings published online on Jan. 20, 2016 in JAMA Surgery.  

"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," the authors added.

In the study, the authors compared more than 25,000 matched pairs of Medicare patients having surgery in 328 hospitals. These pairs were matched based on their surgical procedure, age, sex, severity of illness, demographics and chronic illnesses.

The researchers wanted to find out whether hospitals with better nursing work environments can offer better service compared to those with worse nursing environments. The findings suggest that among Medicare patients who underwent general surgery, the death rate for hospitals with the better nursing environments is 4.8 percent compared to 5.8 percent for those hospitals with worse nursing environments, says Jeffrey H. Silber, MD, PhD, from the Perelman School of Medicine at the University of Pennsylvania in an interview with Medical Research.

Those patients in the highest risk groups gained the most from the benefits of better nursing work environments. There is also less need for the Intensive Care Unit in those hospitals with better nursing environments. And, the study also suggests that the cost per patient need not be higher to provide better value.

"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 percent fewer patients to intensive care units and shortening length of hospital stay," said Linda Aiken, PhD, RN, Director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

The study was conducted by various researchers from the Center for Outcomes Research at The Children's Hospital of Philadelphia, Center for Health Outcomes and Policy Research at Penn's School of Nursing, Penn's Leonard Davis Institute of Health Economics and the Perelman School of Medicine at the University of Pennsylvania. It was funded by the Agency for Healthcare Research and the National Institute of Nursing Research, says a press release from EurekAlert.