A Columbia study found an association between nurse understaffing and healthcare associated infections (HAIs) in patients, demonstrating that understaffing increases the risk of HAIs, which adds billions to annual healthcare costs. HAIs included in the analysis were urinary tract infections, bloodstream infections, and cases of pneumonia. Dr. Elaine Larson, professor of epidemiology at Columbia University Mailman School of Public Health and Anna C. Maxwell Professor of Nursing Research at the School of Nursing, co-authored the research. The findings are published in the Journal of Nursing Administration.
The researchers examined data from more than 100,000 patients in a large urban hospital system and found that 15 percent of patient-days had one shift understaffed with registered nurses below 80 percent of the unit median for a shift and 6.2 percent had both day and night shifts registered nurse (RN) understaffed. Patients on units with both shifts RN understaffed were 15 percent more likely to develop HAIs on or after the third day of exposure to understaffing versus those with adequately staffed shifts. The study also found units were understaffed with licensed practical nurses and nurse assistants which also increased patients’ risk of HAIs.
When a unit was understaffed, nurses in the unit experienced excessive workloads, conditions which may compromise infection prevention practices and surveillance activities intended to recognize signs of infection. Continuous understaffing may also negatively impact nurses’ wellbeing and patient care.
HAIs are serious but often preventable problems. Given the danger and prevalence of the condition — approximately four percent of patients have one or more HAIs during their hospital stays, the U.S. government has taken steps to curbing the incidence of HAIs.