As hospitals cut costs to survive ever-increasing financial pressures, nurses argue that inadequate staffing harms patients. Now members of a University of Pennsylvania research team say they have figured out a key reason for that. The study, which appears Monday in the American Journal of Infection Control, is believed to be the first to examine why staffing matters. It also is among the first to measure the potential harm. If hospitals could reduce their proportion of burned-out nurses to 10 percent from the 30 percent that is typical, according to the study, they would prevent 4,160 cases a year of the two most-common hospital-acquired infections statewide and save $41 million.
The Colorado Court of Appeals ruled Thursday that advanced-practice nurses can administer anesthesia without a doctor's supervision, a ruling the prompted a warning by doctors that patients could suffer serious medical complications and receive inadequate care. The court ruling came in response to a lawsuit filed by the Colorado Society of Anesthesiologists and the Colorado Medical Society seeking to stop the change. Hospitals said the move was necessary because there aren't enough doctors, and the crisis will only get worse as the country adapts to new healthcare laws that open the doors to millions of new patients.
The official guideline from the National Institute for Occupational Safety and Health is that nurses should lift no more than 35 pounds at any given time, but few hospitals and nursing homes follow that rule. Back injuries to healthcare workers cost billions of dollars annually and are a primary reason for nurses choosing to leave the profession. A 2011 health and safety survey from the American Nurses Association showed that disabling injuries from lifting are a top concern among 62 percent of nurses. Eight in 10 nurses said muscle and joint pain is a frequent occurrence.
In January, Nationwide Children's Hospital began requiring new nursing hires to have a bachelor's degree or earn one within five years. Nurses already employed were grandfathered. Research suggests nurses with more advanced degrees are associated "with better rescue of patients who are deteriorating," said Linda Stoverock, Nationwide Children's chief nursing officer. Mount Carmel, OhioHealth and Ohio State University's Wexner Medical Center are setting timetables to reach an Institute of Medicine goal that 80 percent of nurses have a bachelor's degree by 2020. That goal won't be reached through hiring practices alone, said Gingy Harshey-Meade, CEO of the Ohio Nurses Association. Working nurses would have to return to school.
Nurse practitioners and other non-physicians in Kentucky want to practice more independently, or take on more responsibilities, in a largely rural state where 55 of the 120 counties are short on health professionals, according to the federal government. It's a struggle that is playing out in several medical fields. Nurse anesthetists and anesthesiologists, for example, are at odds about Gov. Steve Beshear's April decision to exempt some facilities from a federal requirement that certified registered nurse anesthetists be supervised by a physician.
The state Supreme Court has refused to bar specially trained nurses from giving anesthetics to hospital patients in California without a doctor's supervision. The court's order, issued last week, ends a legal battle between an alliance of nurses and hospitals, on one side, and California physicians, who were joined on the other side by the American Medical Association and doctors' organizations in other states. The order will have its greatest impact in rural areas, where nurses commonly administer anesthesia in hospitals, under a doctor's orders but without in-person supervision.