Impact of Nurse Staffing on Length of Stay
Seven studies found that higher RN-to-patient ratios reduced length of hospital stay and ICU length of stay. This may explain why adequate RN staffing reduced adverse events and decreased LOS. Adequate RN staffing provided better patient monitoring and surveillance as nurses were prepared to detect and treat complications. In addition, RNs were more effective in preventing adverse events such as nosocromial infections and pressure sores than other nursing staff. Adequate RN staffing produced quality infection control practices, permitting them to adhere to aseptic techniques and high standards of care as these principles and techniques require a higher knowledge and skills level. Many studies found the impact of nurse staffing on hospital LOS. Few studies examined the impact on ICU LOS. These studies contribute to the growing evidence supporting that ICUs or general wards can benefit greatly from using the full potential of RNs. The more positive outcomes of sufficient numbers of RNs may be related to the immediate availability of a RN to evaluate and care for patients.
Four studies found that higher ratios of RNs to other nursing staff were associated with reduced LOS. These studies had sufficient data for multiple regression analysis, and research designs to control extraneous factors. One study used nonparametric statistics to test for differences in LOS between two nurse staffing regimens although controlling extraneous factors was difficult due to their small sample size. From these results, one can infer that RNs are more productive than non-RNs because they can perform the entire range of nursing tasks without supervision.