Researchers examined nurse staffing levels and data readmissions penalties for 2,826 U.S. hospitals.
A supplementary analysis found that "a greater proportion of patients in better-staffed hospitals rated their hospital highly and would recommend it to friends and family—factors associated with readmissions and better staffing," the study said. McHugh says that patients at poorly staffed hospitals were more likely to report that they didn't get as good information to prepare for recovery at home.
It's not surprising that nurses with excessive workloads are unable to perform "little" tasks such as properly preparing patients to care for themselves at home.
"The work that nurses do is directly linked to the kinds of things we associate with readmissions," such as discharge planning and care coordination, McHugh says. "Things like patient education get a little bit of a short shrift" when hospitals don't have enough nurses, he adds.
Although hospital leaders might feel gung-ho about new technologies and programs that the PPACA is focusing on, McHugh says all that attention will be for naught without a good foundation of nurses who can actually implement those programs and tools. For instance, "the EHR itself doesn't do anything in terms of care delivery… it requires both the input of the care providers and the uptake of the care providers in order to make it reach its potential," he says.