Nurse staffing and outcomes for pulmonary lobectomy: Cost and mortality trade-offs

• Published in: Heart & lung Vol. 50; no. 2; pp. 206 - 212
• Main Authors: Ross, Hannah I., Jones, Maureen C., Hendriksen, Brandon S., Hollenbeak, Christopher S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2021
• Subjects: Costs; Hospital Mortality; Hospitals; Humans; Nurse staffing; Nurses; Nursing Staff, Hospital; Outcomes; Personnel Staffing and Scheduling; Pulmonary lobectomy; Workforce; Pulmonary lobectomy; Costs; Outcomes; Nurse staffing
• ISSN: 0147-9563; 1527-3288
• DOI: 10.1016/j.hrtlng.2020.12.001

•Utilization of more RNs was associated with better outcomes following lobectomy•Patients treated at hospitals using more RNs had lower mortality and shorter LOS•Patients treated at hospitals using more RNs had significantly higher costs•Administrators face a trade-off between outcomes and costs in this patient population
Nurse staffing impacts patient outcomes, but little is known about the relationship between nurse staffing and outcomes for lung cancer patients undergoing pulmonary lobectomy.
To examine the association between nurse staffing and outcomes following lobectomy for lung cancer.
Patients (N = 16,994) with lung cancer between who underwent lobectomy between 2008–2011 were identified in the National Inpatient Sample. Nurse staffing was quantified using registered nurse full-time equivalents per adjusted patient days. Multivariable models were used to estimate the effect of RN FTEs on mortality, length of stay, and costs, controlling for covariates.
Patients treated at hospitals using 5.6 or more RN FTEs had shorter hospitals stays by 0.37 days (p = 0.008), had 36% lower odds of mortality (OR = 0.64, p = 0.014), but incurred $4,388 (p < 0.0001) in additional costs.
Hospital administrators face a troubling trade-off between costs and outcomes in decisions about nurse staffing mix for pulmonary lobectomy.