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.
A new study from the University of Pennsylvania School of Nursing’s (Penn Nursing) Center for Health Outcomes & Policy Research is the first of its kind to describe the relationship between medical-surgical nurse staffing and its association with racial disparities in survival after IHCAs. It suggests that while the likelihood of survival to discharge after an IHCA is lower for black patients than for white patients in both poorly staffed and well-staffed hospitals, the survival difference produced by better staffing is more pronounced for black patients than for white patients.
“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,” says J. Margo Brooks Carthon, PhD, RN, FAAN, Associate Professor of Nursing at Penn Nursing and lead author of the study. “The findings are consistent with a growing number of studies that suggest that hospital-based disparities may be related to variation in nursing care quality in the settings where black patients receive care.”
The study included more than 14,000 patients in 75 U.S. hospitals. The article, “Better Nurse Staffing Is Associated With Survival for Black Patients and Diminishes Racial Disparities in Survival After In-Hospital Cardiac Arrests” is set for publication in the journal Medical Care.
Coauthors include Heather Brom, PhD, APRN; Matthew McHugh, PhD, JD, MPH, RN, FAAN; Douglas M. Sloane, PhD; and Linda H. Aiken, PhD, FAAN, FRCN, all of Penn Nursing; Robert Berg, MD of the Children’s Hospital of Philadelphia; Raina Merchant, MD, MHSP, FAHA of the Hospital of the University of Pennsylvania; and Saket Girotra, MD, SM of the Iowa City Veterans Affairs Medical Center.