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Established in 1989 as one of the first centers to scale up rigorous research on the impact of nursing on patient outcomes, the Center uses evidence to inform policy and produces the next generation of scientists.

Safe Nurse Staffing Standards in Hospitals Saves Lives and Lowers Costs

A new study published in The Lancet Global Health showed that establishing safe nurse staffing standards in hospitals in Chile could save lives, prevent readmissions, shorten hospital stays, and reduce costs.

July 6, 2021 | The study, by the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing, and the Universidad de los Andes - Chile School of Nursing, found very large variations in patient to nurse staffing across 40 hospitals located throughout Chile. Nurse staffing was significantly better in private compared to public hospitals. Differences in nurse staffing across public hospitals were found to be associated with avoidable deaths and higher than necessary costs. More

Minimum Nurse-to-Patient Ratios Policy Saves Lives and Lowers Costs

Dr. Matthew McHugh discusses Queensland study findings with reporters in Australia.Dr. Matthew McHugh discusses Queensland study findings with reporters in Australia.May 12, 2021 | A new study published in The Lancet today showed that a policy establishing minimum nurse-to-patient staffing ratios in hospitals in Queensland, Australia saved lives, prevented readmissions, shortened hospital stays, and reduced costs.

The study, by the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing, and the Queensland University of Technology School of Nursing, evaluated legislation enacted in 2016 as a safety measure. The new policy limited the average number of patients per nurse to four, similar to pending legislation in New York and Illinois. “The positive results in Queensland should inform policies in the U.S. and elsewhere,” said lead-author Matthew McHugh, PhD, the Independence Chair for Nursing Education and CHOPR Director. More

Ischemic stroke patients spend less time in the hospital and are less likely to be readmitted when the hospital has better nurse work environments. 

J. Margo Brooks Carthon, PhD, RN, FAAN, Associate Professor of Nursing and co-author..J. Margo Brooks Carthon, PhD, RN, FAAN, Associate Professor of Nursing and co-author..In a new study from the Center for Health Outcomes and Policy Research (CHOPR), researchers evaluated the association between the nurse work environment and readmission and length of stay for close to 200,000 hospitalized adult ischemic stroke patients in more than 500 hospitals. They found that in hospitals with better nurse work environments, ischemic stroke patients experienced lower odds of 7‐ and 30‐day readmissions and lower lengths of stay.

Their research has been published in the journal Research in Nursing & Health. The article “Better Nurse Work Environments Associated with Fewer Readmissions and Shorter Length of Stay Among Adults with Ischemic Stroke: A Cross‐Sectional Analysis of United States Hospitals” is available online. More

“The work environment is a modifiable feature of hospitals that should be considered when providing comprehensive stroke care and improving post‐stroke outcomes,” says Heather Brom, PhD, RN, NP-C, lecturer at Penn Nursing and lead author of the article. “Our findings have important implications for quality improvement initiatives for stroke care management.”

Closing the Racial Disparity Gap in Survival After In-Hospital Cardiac Arrest

In-hospital cardiac arrests (IHCA) represent catastrophic and often terminal events. Despite investments to improve the quality of resuscitation efforts, fewer than 25 percent of all patients that experience cardiac arrests in hospitals survive to discharge, and survival varies significantly across hospitals and by race. Until now, few have been able to specify reasons for the between-hospital differences. More

“The effect of being cared for in hospitals with better medical-surgical staffing has a greater effect on black patients than white patients, and differences in survival to discharge after an IHCA between black and white patients are more pronounced in poorly staffed hospitals than in well-staffed hospitals.” 

Karen Lasater, PhD, RN, Assistant Professor of NursingKaren Lasater, PhD, RN, Assistant Professor of NursingNew York State’s Hospital Nurse Staffing Legislation Predicted to Save Lives and Money

According to a new study published in Medical Care, improving hospital nurse staffing as proposed in pending legislation in New York state would likely save lives. The cost of improving nurse staffing would be offset by savings achieved by reducing hospital readmissions and length of hospital stays. More

Other recent publications from this same study by the Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing showing that mandating minimum nurse staffing standards in the New York state are in the public’s interest:

Lasater KB, Sloane DM, McHugh MD, Cimiotti JP, Riman KA, Martin B, Alexander M, Aiken LH. Evaluation of hospital nurse-to-patient ratios and sepsis bundles on patient outcomes. American Journal of Infection Control. 2020.  Open Access.

Lasater KB, Aiken LH, Sloane DM, French R, Martin B, Reneau K, Alexander M, McHugh MD. 2020. Chronic hospital nurse understaffing meets COVID-19. BMJ Quality & Safety. Epub ahead of print 18 August 2020. doi:10:1136/bmjqs-2020-011512. Open Access.

The study was carried out by the Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing in partnership with the National Council of State Boards of Nursing. Funding for the study was from the National Council of State Boards of Nursing, the National Institute of Nursing Research/NIH, and the Leonard Davis Institute of Health Economics at the University of Pennsylvania.