Emory nursing school study: More time with an RN improves sepsis outcomes

Nine more RN hours per patient day would have saved an estimated 6,360 patients, analysis finds

5 facts about the U.S. nursing shortage.According to research in the American Journal of Medical Quality, a shortage of registered nurses is projected to spread between 2009 and 2030.The South and West, authors forecast, will suffer the greatest RN shortage.The shortage is due to a variety of factors, including an aging workforce. A 2013 survey found 55 percent of RNs are 50 or older.According to the American Association of Colleges of Nursing, a shortage of nursing school faculty is also restricting nursing program enrollments.And nursing school enrollment just isn't growing fast enough to meet the demand for services

A few more hours under the care of a registered nurse can improve a patient’s sepsis outcome, according to a new study out of the Nell Hodgson Woodruff School of Nursing at Emory University.

Led by Jeannie Cimiotti, PhD, RN, of Emory’s nursing school, the analysis of more than 700,000 Medicare patients with sepsis in 2018 found that with each additional hour a patient was with an RN each day, there was a 3% decrease in the likelihood of death at 60 days.

“The study findings suggest that nurse workload is an overlooked and underused aspect of the treatment bundle for patients with a diagnosis of sepsis,” Cimiotti wrote.

Put in context, that means of the more than 180,000 patients who died of sepsis during the study period, 1,266 would have survived if hospitals had added six more RN hours per patient each day, the researchers estimated. Nine more RN hours per patient day would have saved an estimated 6,360 patients.

Sepsis is a physiologic response to infection that, if not managed properly, can lead to multiorgan failure and death, the researchers wrote.

“The sepsis patient requires complex care, and if you don’t have enough nurses on staff to address those patient care needs, unfortunately, your outcomes are going to be worse,” Cimiotti told MedPage Today. “If they’re short-staffed or overworked ... you’re going to lose that window of opportunity.”

The research was conducted before the pandemic, with more nurses on staffs nationwide than there are today.

The full study can be read on JAMA Health Forum.

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