Better nurse staffing levels tied to lower readmissions rates: study

A better work environment and improved staffing levels for nurses could mean lower rates of hospital readmissions, according to a study.

Published the in the journal Medical Care, the Robert Wood Johnson Foundation-funded study used nurse survey data and patient discharge data from three states to determine the relationship between 30-day rehospitalizations and nursing factors such as education, environment and workload.

Nurses' per-patient load had a significant effect on readmission rates for heart attack, heart failure and pneumonia, the three conditions covered in the CMS' recently launched readmissions reduction program. For each additional patient added to a nurse's workload, the odds of readmission rose by 9% for heart attack, 7% for heart failure and 6% for pneumonia.

Additionally, the study's authors found that care received in a good work environment for nurses—based on surveyed variables such as nurse-physician relations and nurse leadership in hospital affairs—was also associated with lower rates of readmissions for all three conditions.

Nurses' level of education, on the other hand, was not associated with readmission risk among heart failure or heart attack patients. But higher proportions of nurses with bachelor's degrees were associated with 3% lower odds of readmission among pneumonia patients.

“Our findings indicate that improving nurses' work environments and reducing their workloads can reduce readmissions for Medicare patients with common conditions,” Matthew McHugh, an assistant professor at the University of Pennsylvania School of Nursing, and the study's lead author, said in a news release. “It is certainly worthwhile for hospital administrators to examine these two factors and explore whether they can be optimized to improve patient outcomes and reduce readmissions.”

The study is not the first to indicate a link between nurse staffing levels and readmission rates. A 2011 study in the journal Health Services Research, also funded by the RWJF, found that hospital units with greater numbers of registered nurses and fewer nurse overtime hours had lower rates of readmissions.