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Patient outcomes are affected by nurses’ working environment

Patient outcomes are affected by nurses’ working environment

A US study has shown that nurses who are more productive could help reduce the number of patients who have to undergo surgery and then need intensive care.

The journal published the research Advanced Critical CareThis includes data from 453 US hospitals on more than 269,000 adult patients who had general, orthopaedic, or vascular surgery between 2006-7.

If hospitals had good nurse work environments before the pandemic, fewer ICU beds might have been required.

Anna Krupp

These hospitals’ nurse work environments were assessed using data collected from 34,000 registered nursing staff.

Each hospital was assigned a score based its performance in five areas: nurse participation in hospital affairs; nursing foundations to quality of care; leadership and support of nurses; staffing and resources; and communication between nurses & physicians.

Hospitals that scored in the top 25% were classified as good, while those in the middle 50% were considered to be mixed and the bottom 25% were poor.

Researchers found that patients who had surgery had better outcomes if they had a good nurse work environment.

In good hospitals, 12% were admitted to the ICU and died within 30 days. This is compared to 13.4% for mixed hospitals and 16% for poor hospitals.

Furthermore, patients who had surgery were 29% less likely be admitted to an ICU and 21% more likely to die within 30 day of admission if they were treated in a good hospital.

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Researchers concluded that early interventions to improve nurse work environments, such as strategies for encouraging nurse leadership and the introduction of adequate staffing models could make hospitals more resilient to the ICU capacity demands experienced during emergencies.

Anna Krupp, a registered nurse and assistant professor at University of Iowa College of Nursing, stated that hospitals might have been more able to withstand the pressures placed on ICUs by the surges of critically ill patients.

She said that in the context the Covid-19 pandemic, we found that a hospital’s ability to respond to Covid-19 surges is affected by the quality of its nurse work environments.

She said that ICU beds may not have been as necessary if hospitals had adequate nurse work environments before the pandemic. There were enough nurses to care for patients in lower acuity settings.

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