Higher levels of nurse staffing can lead to better patient outcomes, but not necessarily in safety net hospitals, according to a report published in Medical Care, a journal of the American Public Health Association.

In a study funded by the Robert Wood Johnson Foundation's Interdisciplinary Nursing Quality Research Initiative, researchers examined discharge records for 1.1 million patients in 872 units—including 285 intensive-care units—at 54 University HealthSystem Consortium hospitals and looked for a relationship between patient outcomes and the hours of nursing care patients received.

Although staffing levels were said to be the same, outcomes were better in nonsafety net facilities, where higher nurse staffing and a larger number of registered nurses were associated with lower mortality rates from congestive heart failure, lower rates of infection and bed sores, and shorter lengths of stay. There were also fewer “failure to rescue” deaths, where deaths occurred after nurses did not note or initiate treatment in life-threatening situations, according to a Robert Wood Johnson Foundation news release.

Safety net status was linked to more bed sores and more congestive heart failure and failure-to-rescue deaths, the report stated.

“We suspect that the increase in mortality rates due to congestive heart failure in safety net hospitals are a function of patients' overall health, rather than staffing rates, but more research needs to be done,” said lead researcher Mary Blegen, a nurse and professor at the University of California San Francisco School of Nursing, in the news release.