Study finds link between nurse staffing level, work conditions and in-hospital cardiac arrest outcomes

Though patients who experience cardiac arrest in hospitals have a greater chance of early intervention, less than a quarter of patients survive such incidents. A study published in Medical Care has identified a link between high level of nurse staffing, good work conditions and improved survival rates for in-hospital cardiac arrests.

"These results add to a large body of literature suggesting that outcomes are better when nurses have a more reasonable workload and work in good hospital work environments," Matthew McHugh, PhD, RN, associate director of the Center for Health Outcomes and Policy Research, said in a statement. "Improving nurse working conditions holds promise for improving survival following [in-hospital cardiac arrests]."

Researchers looked at a data from more than 11,000 adult patients who experienced cardiac arrests in 75 hospitals across four states between 2005 and 2007. This data, taken from the American Heart Association's "Get With the Guidelines-Resuscitation" database was combined with national survey data on nurse staffing in hospitals.

Of the patients who suffered in-hospital cardiac arrest, only 15 percent survived to discharge, most occurred in ICUs, 80 percent of the events were witnessed by staff and 88 percent of patients were on monitoring equipment when cardiac arrest occurred. Patients who were monitored were more likely to survive, as well as patients who were in better-staffed environments — each additional nurse in a medical-surgical unit was associated with a 5 percent relative reduction in the odds of survival. For hospitals with poorer work environments, likelihood of survival was 16 percent lower.

The results add to literature that suggests patient outcomes are better when nurses have a more reasonable workload and efforts to improve their work conditions hold promise for improving in-hospital cardiac arrest survival, the authors conclude.

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