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Good News for Pediatric Nurses - Better Staffing Reduces Hospital Readmission Rates

A new study by my colleague Heather Tubbs-Cooley, PhD, RN out of Cincinnati Children's Hospital demonstrated that better RN to patient ratios mean reduced readmission rates between 15 and 30 days after hospital discharge.  From the study published in the British Medical Journal of Quality & Safety:

"Each one patient increase in a hospital's average paediatric staffing ratio increased a medical child's odds of readmission within 15–30 days by a factor of 1.11, or by 11% (95% CI 1.02 to 1.20) and a surgical child's likelihood of readmission within 15–30 days by a factor of 1.48, or by 48% (95% CI 1.27 to 1.73). Children treated in hospitals with paediatric staffing ratios of 1 : 4 or less were significantly less likely to be readmitted within 15–30 days. There were no significant effects of nurse staffing ratios on readmissions within 14 days." 

Weaknesses of the study include that it does draw from a dataset of nurse survey responses from four US states and the data is about five years old.  Nonetheless, the sample size was large enough to determine if staffing has an effect on hospitalized pediatric patient outcomes.

With the implementation of the Affordable Care Act coming around the corner, studies like these are important because they show where cost savings can occur with better management.  More nurses often seem like an expensive intervention, but this type of study helps to show how good nursing care pays for itself.

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