Impact of the nurse shortage on hospital patient care

May 9 2007

Physicians, nurses and hospital administrators voice their concerns about the nursing shortage in a new study by Peter Buerhaus, Ph.D., professor of Nursing at Vanderbilt University and director of the Center for Interdisciplinary Workforce Studies at the Medical Center.

The study is featured in the May/June issue of the journal, Health Affairs.

Buerhaus and his colleagues conducted three random surveys from January 2004 through March 2005 to gauge the impact of the nursing shortage. They surveyed registered nurses, physicians, hospital chief nursing officers and hospital chief executive officers. The results showed that the nursing shortage has negatively impacted communication, nurse-patient relationships, and timeliness of care and overall efficiency.

“We wanted to conduct a survey of those who are dealing with the impact of the nursing shortage every day,” said Buerhaus.

The study findings also showed areas of disagreement between the different groups of participants. Registered nurses and chief nursing officers share common perceptions, but physicians and chief executive officers do not. The major differences surround issues of patient safety and the quality of the nurses' work environment. The nursing-related groups were concerned about the impact of the shortage on early detection of patient complications as well as patient safety. Those who work directly with patients believed the nursing shortage was negatively impacting national quality improvement goals.

“It is surprising that physicians and hospital chief executives are less likely to perceive that the nursing shortage negatively affects patient care safety,” Buerhaus added.

The authors believe the study supports the need to develop team communication and collaboration to improve patient care and patient safety. They suggest building on areas of common concern and understanding to address specific needs that will improve patient care.

“The important issue is to isolate the areas of agreement and disagreement as a crucial step toward getting the chief clinical and administrative leaders in hospitals to first recognize the problem by interacting together as a team to understand how and why their perceptions of nursing shortage differ, and to discover where they share common perceptions,” said Buerhaus. “With this understanding, clinicians and administrators, as a team, can develop and implement strategies aimed at combating the shortage and working more closely together.”

They underscore that overall patient care is a collaborative goal that requires an interdisciplinary team approach and that focusing on communications will help strengthen the relationships between health providers and increase the quality of patient care.

“We may not be able to reverse the nursing shortage completely,” said Buerhaus. “However, we can focus on building stronger team communication among providers and executives to ensure safer environments for patients, even in the face of a shortage of nurses.”

“Impact of the Nurse Shortage on Hospital Patient Care: Comparative Perspective,” by Buerhaus and colleagues is available in the May/June issue of Health Affairs. Published by Project HOPE, Health Affairs is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research. Copies of the issue will be provided free to interested members of the press. Address inquiries to Christopher Fleming at Health Affairs, 301-347-3944, or via e-mail, [email protected]. Selected articles from the issue are available free on the journal's Web site,http://www.healthaffairs.org .