RN staffing linked to safe practices adoption

A new study found more nurse-hours per patient and larger percentages of RNs on staff as factors in higher adoption levels of safe practices.

The finding was part of a study examining the higher likelihood of designated Magnet hospitals, when compared with non-Magnet hospitals, to adopt National Quality Forum Safe Practices.

Since 1993, the American Nurses Credentialing Center has certified 383 Magnet hospitals based on their commitment to and success in providing high-quality practice environments for nurses to provide high-quality patient care. These hospitals have been widely recognized for high retention rates among nurses and positive work environments.

But little information has been available regarding Magnet hospitals’ adoption of safe practices compared with other hospitals, according to the study, which was published in the Journal of Nursing Administration and funded by a grant from the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative.

A team of researchers reviewed data from surveys of 140 Magnet Hospitals and 1,320 non-Magnet hospitals in 34 regions over three years to ascertain whether Magnet hospitals reported higher rates of adopting and implementing National Quality Forum Safe Practices, and the characteristics that lead to higher adoption and implementation rates.

A private nonprofit organization that develops and implements a national strategy for healthcare quality measurement and reporting, the NQF has endorsed 30 evidence-based practices that improve patient safety (see links at https://bit.ly/cNYpHD).

The researchers found that Magnet Hospitals tend to have more beds and are more likely to be nonprofit and have a lower percentage of Medicaid patients compared to non-Magnet hospitals. Magnet hospitals also are better equipped with advanced clinical technologies and have a higher percentage of RNs and higher nursing hours per patient-day than non-Magnet hospitals.

Although size and the number of Medicaid patients did not affect the adoption of NQF Safe Practices, higher numbers of nurse hours per patient, larger proportions of RNs and high levels of competition with other hospitals all correlated with higher levels of NQF Safe Practices adoption.

“Our findings suggest that having more nurses than necessary to meet minimum patient needs is key to adopting these practices, which require activities like conducting meetings, collecting and analyzing data, and reviewing the literature on safe practices,” said study author Jayani Jayawardhana, PhD, assistant professor at the College of Public Health at the University of Georgia.

“As hospitals continue to search for ways to cut costs in order to survive in the current economy, we are concerned that some cost-cutting measures may have a negative impact on hospitals’ ability to adopt safe practices and provide the highest levels of patient care.”

The authors did note that several non-Magnet hospitals were also successful in adopting and implementing many or all of the NQF Safe Practices, so the Magnet credential is not a prerequisite for success in adopting them. The study also found that over time, more Magnet and non-Magnet hospitals were adopting more of the practices.

To view a study summary, visit https://bit.ly/qonq5L.

Posted September 29, 2011.