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Medical
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Serious Health Risks Posed by
Lack of Nurses
A new study shows that inadequate nursing care can cause
devastating problems for patients. It is surprisingly difficult, however, for most people
to get basic information about nursing levels at individual hospitals.
When there are too few registered nurses at bedsides,
patients are significantly more likely to suffer serious complications, such as
urinary-tract infections, internal bleeding and even death, according to the study,
published in the New England Journal of Medicine. (ed. note: How does this affect the
medical malpractice? Consult an attorney.)
The findings which come amid a prolonged nursing shortage,
suggest that patients should consider how many registered nurses are on hand when choosing
a hospital. Although people increasingly can shop for a hospital based on such available
data as death rates for specific procedures, nursing information is more elusive.
Patient-to-nurse ratios are particularly critical
information. For instance, hospital stays are 3% to 5% shorter when levels of registered
nurses are high, says the lead author of the study, Jack Needleman, an assistant professor
of economics and health policy at the Harvard School of Public Health. And in hospitals
with a high proportion of registered nurses, so-called "failure to rescue"
deaths - those that might have been prevented if warning signs were caught early - were
2.5% lower. (ed. note: The number of medical malpractice cases may also be affected.
Consult an attorney.) Registered nurses have the highest level of training.
The researchers , from Harvard and the Vanderbilt School of
Nursing, divided hospitals evenly into four groups, ranked according to the number of
patients per registered nurse. Patients in the top-staffed hospitals were 3.6% less likely
than those in the bottom groups to get urinary-tract infections, a condition that
generally requires treatment with antibiotics. Patients at these hospitals were 5.2% less
likely to have gastrointestinal bleeding and 2.7% less likely to get pneumonia.
The top-staffed hospitals in the study had an average of 2.7
patients per nurse, while the bottom ones had an average of 3.8 patients per nurse. But
many hospitals around the country have far worse average breakdowns, and some are working
with ratios as high as 10 patients per nurse in individual wards. Average levels combine
the very personalized nursing of intensive-care units, where nurses may care for only one
patient, with those from standard medical wards, where nurses commonly care for a handful
of patients at a time.
Though a worrisome shortage persists, nurse-staffing levels
actually have increased in recent years. However, many industry experts believe that
the rise hasn't kept pace with the increasing severity of illness seen in hospitals. The
so-called "case mix" are becoming more ill as more patients are steered into
outpatient surgery. Despite improvement in staffing, some 13% of nursing vacancies are
still unfilled.
During a hospital stay, family members can be helpful in
looking out for patients' needs and pointing out potential problems to busy nurses,
clinicians say. Hiring a private-duty nurse could improve comfort, but might backfire by
diminishing attention from staff nurses, who have the power and know-how to get things
done in the hospital. (Source
- The Wall Street Journal - May 30, 2002)
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