Study: “Team nursing” at odds with patient safety; alternative staffing solutions recommended

Editor's Note

Substituting lower-wage staff for registered nurses leads to additional patient deaths, the Washington Post reported on June 15.

The article focuses on a study published in the journal Medical Care, noting that the new research coincides with a nationwide shortage of RNs and “reports of widespread burnout.” Researchers focused on the impact of “team nursing,” a common strategy for addressing staffing shortfalls in which fewer RNs supervise lower-wage healthcare workers. Analyzing data from 2,676 hospitals and nearly 6.6 million Medicare beneficiaries, they found that a 10% reduction in RN staffing would increase a patient's odds of dying in the hospital by 7% and within 30 days of discharge by 4%, as well as increase the length of hospital stays and the likelihood of readmission. This reduction could result in 10,947 additional deaths and 5,207 avoidable readmissions per year, costing Medicare $68.5 million and hospitals $2.9 billion in cost savings due to longer stays.

As an alternative to team staffing, the researchers recommend improving working conditions for RNs by reducing understaffed shifts, funding more positions, and addressing nurse burnout, The Post reports.  They also suggest setting minimum RN staffing requirements to protect patient safety. RNs constituted an average of 76.5% of hospital staff in 2019.