Lower surgical mortality in hospitals with best nursing care, novel study shows

"We found that patients treated in hospitals with better nursing had significantly lower death rates after surgery," said lead author Jeffrey H. Silber, MD, PhD, Director of the Center for Outcomes Research at The Children's Hospital of Philadelphia and Senior Fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania. The outcomes advantage for patients in Magnet hospitals was greater for all patients but especially for sicker and more complicated patients.

"Magnet designation for nursing excellence offers a way for patients to easily identify hospitals where they are more likely to have good outcomes following surgery," said study co-author Matthew McHugh, PhD, JD, MPH, RN, Associate Director, Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

The authors used a novel approach to compare 25,076 matched pairs of Medicare patients having surgery in 328 hospitals. Pairs of patients had the exact same surgical procedure and were very similar in terms of age, sex, severity of illness, demographics, and chronic illnesses.

"A surprising finding was that better nurse staffing throughout the hospital does not have to be more costly. Indeed, we found that Magnet hospitals achieved lower mortality at the same or lower costs by admitting 40 percent fewer patients to intensive care units and shortening length of hospital stay," said Linda Aiken, PhD, RN, Director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.