A new study published in Medical Care today showed that substituting registered nurses (RN) with lower-wage staff (e.g. licensed practical nurses, unlicensed assistive personnel) in hospital care is linked with more deaths, readmissions, longer hospital stays, poorer patient satisfaction, and higher costs of care.
The study, by the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing (Penn Nursing), comes at a time when hospitals are struggling to recruit and retain RNs in hospital care because of poor working conditions. "Nurses in hospitals provide care for the sickest patients. It's high stakes care.
The findings show that replacing RNs with non-RN staff is dangerous to patients," said lead-author, Karen Lasater, PhD, RN, Associate Professor and the Jessie M. Scott Term Chair in Nursing and Health Policy. Though hospitals often cite a low supply of RNs as the reason they cannot hire enough, the latest research shows there is no evidence of an RN shortage in the US.
Thus, there is no justification for substituting less qualified staff for RNs. The researchers studied the outcomes of over 6.5 million Medicare patients in 2,676 general acute care hospitals across the U.
S. They found that: The public has no way of assessing the adequacy of hospital RN staffing, and in all but two states (California and Oregon) there are no regulations establishing minimum safe RN staffing requirements in hospitals to protect the safety of p.