Excessive Use of Overtime, Agency Nurse Hours Increase Rates of Patient Safety Indicators
WEDNESDAY, April 9, 2025 -- Excessive use of overtime and agency nurse hours are associated with increased rates of pressure ulcers in U.S. hospitals, according to a study published online April 2 in JAMA Network Open.
Patricia Pittman, Ph.D., from George Washington University in Washington, D.C., and colleagues examined whether overtime and agency nurse staffing hours are associated with hospital patient safety. The analysis included data from 70 U.S. hospitals (2019 through 2022).
The researchers found that the average use of nurse overtime and agency nurse hours exceeded safe thresholds for pressure ulcers by 140.0 percent for agency staffing and by 63.6 percent for overtime, representing a 6.44 percent increase associated with excess agency nurse hours and a 2.09 percent increase for excess use of overtime. Agency hours were also significantly associated with postsurgery hemorrhage or hematoma rates but no breakpoint threshold. No significant associations were seen with other U.S. Agency for Healthcare Research and Quality patient safety indicators.
"These findings suggest that both nurse overtime and nurse agency hours are associated with increased rates of pressure ulcers, a measure that is one of the most sensitive to nursing care," the authors write. "In future research, hospitals could use their own data to track safe thresholds."
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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