Harvard university study identifies inadequate nurse staffing as a major factor in medical errors

Nevada RNformation, Feb 2003

Doctors and general public agree shortages of nurses and overwork / stress are to blame; public still rates nurses as no. 1 in 'honesty and integrity'

More than one-third of practicing physicians and 40 percent of the public say they or a family member have experienced a medical error, according to a survey reported Dec. 12 in the New England Journal of Medicine. And, while the two groups diverged on possible causes and solutions, both ranked shortages of nurses; and overwork, stress and fatigue among health care workers as "very important" causes of errors.

Specifically, the survey found that more than 53 percent of physicians and 65 percent of the public cited understaffing of nursing in hospitals as a factor in errors, while 50 percent and 70 percent of physicians and the public, respectfully, blamed errors on overworked, stressed or fatigued health care workers. The survey was conducted last spring by researchers at the Henry J. Kaiser Family Foundation and the Harvard School of Public Health.

"This study provides more evidence of the impact of nurses' working conditions on patients," said ANA President Barbara Blakeney, MS, APRN,BC, ANP. "The results point to the fact that medical mistakes are common and that both physicians and the public see inadequate nurse staffing as a significant cause of errors."

As many recent reports and studies have illustrated, nurse staffing is insufficient in many health care facilities today, resulting in preventable complications and even patient deaths in some cases. Insufficient nurse staffing also increases nurse burnout, fueling an exodus from the profession, thereby further exacerbating the growing shortage of nurses.

The NEJM study results also come on the heels of a January 2003 Consumer Reports cover story, based on a survey of nearly 21,000 readers, which reveals that an enormous variance exists in the quality of care patients receive, with much of that variability being attributed to whether a facility has an adequate staff (especially nurses) along with a well-organized care system.

"All of these studies demonstrate the need to make adequate nurse staffing a national priority," Blakeney said.

In the meantime, the nation's nurses again ranked number one for their honesty and integrity in this year's CNN/USA Today/Gallup Poll, with 79 percent of Americans rating them "high" or "very high." Nurses have been the highest rated profession since first being included in Gallup's "Honesty and Integrity" survey in 1999, except in 2001, when firefighters outranked them in wake of the Sept. 11 terrorist attacks. (Firefighters were not included in this year's poll.)

"The rating of nurses by the public as number one in 'honesty and ethics' is a real compliment because it reveals just how much trust the public places in the nursing profession," said Blakeney. "The public expects to receive quality nursing care and they trust nurses to be their advocate. That's why ANA is on a mission to transform health care facilities into safe places for patients."

In addition, Blakeney expressed hope that "the continuing affirmation of the public's respect and trust in nursing will prompt Congress and the health care industry to take action to improve the work environment for nurses," by eliminating forced overtime and other unsafe staffing practices. "What we need, in short, is the public's support on such issues, along with decision makers' readiness and willingness to act."

In addition to nurses, other top-ranking professions in the Gallup survey include pharmacists (at 67 percent, and the previously highest rated profession before nurses were included), military officers (a new addition, at 65 percent), high school teachers (64 percent) and medical doctors (63 percent). The Gallup poll was conducted on November 22-24. Go to www.gallup.com/poll/releases/pr021204.asp to read full report. Full results of the errors study are available at the Kaiser Family Foundation Web site, www.kff.org.

ANA is the only full-service professional organization representing the nation's 2.7 million Registered 'Nurses through its 54 constituent associations, which includes the Nevada Nurses Association. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.