Quality Outcomes of Hospital Supplemental Nurse Staffing

Use of supplemental RNs (SRNs) is common practice among US hospitals to fill gaps in nurse staffing. The objective of this study was to examine the relationship between use of SRNs and patient outcomes. Multilevel modeling was performed to analyze hospital administrative data from 19 hospital units in a large tertiary medical center for the years 2003 to 2006. Patient outcomes included in-hospital mortality, medication errors, falls, pressure ulcers, and patient satisfaction with nurses. Use of SRNs ranged from 0% to 30.4% of total RN hours per unit quarter.

Cost Outcomes of Supplemental Nurse Staffing in a Large Medical Center

Use of agency-employed supplemental nurses on nursing personnel costs was examined in 19 adult patient care units in a large academic medical center. Results indicated that the modest use of supplemental nurses was cost-efficient with regard to overall nursing personnel costs, but heavy reliance on supplemental nurses to meet staffing needs was not cost-efficient. In addition, there was no statistical difference in hourly personnel cost between the use of supplemental nurses and overtime worked by permanent nurses.

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