Study finds nursing staff levels improve patient care, but not always in safety-net hospitals

A study in Medical Care has found that while higher levels of nursing staff improve patient outcomes in many cases, the effect may be minimal in safety-net hospitals that serve vulnerable populations. 

Key findings from the study include:

  • Higher total nursing staffing  in general adult units in non-safety-net hospitals was associated with lower CHF mortality rates, lower rates of infection due to medical care, and fewer patients with length of stay greater than expected
  • Safety-net hospitals with higher total staffing had fewer patients with extended length of stay, and greater than expected and higher rates of CHF mortality.
  • Failure to rescue rates were lower in all hospitals when RN skill mix was higher in general units.
  • Infections due to medical care were lower in non-safety-net hospitals with higher RN mix and higher total staffing.
  • Safety-net hospitals in this study had higher rates of CHF mortality, decubitus ulcers, and failure to rescue than in non-safety net hospitals. 

The authors conclude that more research is needed to examine the differences in nursing staff in safety-net vs. non safety-net hospitals. 

(Sources: The Advisory Board Daily Briefing,, March 28, 2011; Medical Care,, April, 2011)