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Eliminating Nursing Understaffing Aids Hospital Outcomes

Medically reviewed by Carmen Pope, BPharm. Last updated on May 1, 2025.

By Lori Solomon HealthDay Reporter

THURSDAY, May 1, 2025 -- Addressing nursing understaffing improves outcomes for hospitalized patients, according to a study published online April 29 in BMJ Quality & Safety.

Christina Saville, from the University of Southampton in the United Kingdom, and colleagues assessed whether hospital investment in nursing staff, to eliminate understaffing, is cost-effective. The analysis included data from 185 adult acute units in four hospital Trusts in England during a five-year period.

The researchers found that exposure to registered nurse (RN) understaffing is associated with an increased risk for death (adjusted hazard ratio [aHR], 1.079), increased chance of readmission (aHR, 1.010), and increased length of stay (ratio, 1.687). Exposure to nursing support (NS) understaffing is associated with smaller increases in hazard of death (aHR, 1.072) and length of stay (ratio, 1.608) but not reduced readmissions (aHR, 0.994). The estimated cost to eliminate both RN and NS understaffing would be an estimated £2,778 per quality-adjusted life year (staff costs only) or £2,685 (including benefits of reduced staff sickness and readmissions), or a savings of £4,728 (including benefits of reduced lengths of stay). Compared with using permanent members of staff, using agency staff to eliminate understaffing is less cost-effective and would save fewer lives.

"When considering alternative policy strategies, this study indicates the importance of prioritizing investment in RNs employed on wards over support staff, as well as showing there are no shortcuts to employing enough RNs, as using temporary staff is more costly and less effective," the authors write.

Abstract/Full Text

Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

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