Nurse Staffing Shortages Correlate to Increased Risk of Patient Death, Study Finds

• A new study from JAMA Network Open investigates the relationship between nurse staffing shortages and the risk of patient death.
• Its findings show a “statistically significant increase” in risk of death when staffing is lower.
• The study comes as nurses throughout the United States are voicing concerns about staffing levels and how that alters the quality of care they provide.

Patients have a higher risk of dying when there’s inadequate nurse staffing, according to a new study out of the United Kingdom. 

The health policy investigation, published in August 2024 in “JAMA Network Open,” explored the association between the makeup of a nursing staff and the risk of patient death.  

These findings come as practitioners throughout the United States are speaking out about nurse staffing shortages and their impact on the quality of patient care. 

‘Statistically Significant’ Findings

In studying more than 600,000 patients, the study authors found a “statistically significant increase” in the risk of death when nurse staffing was low. 

While the risk of death varied with the experience level of nurses on duty, it wasn’t clear if more tenured nurses or temporary staff “could fully compensate for the effect of low staffing,” the authors stated. Their results could also indicate there’s still an increased risk of death even when temporary staff is brought in to help with low staffing. 

“While our findings show the importance of considering the mix of staff, as well as absolute numbers, the largest effect sizes observed were those associated with low staffing,” the authors stated. “This finding challenges the assumption that temporary staff are a cost-effective long-term solution to maintaining patient safety.” 

Nurse Staffing Shortages in the US

Gloria Wolfe, an RN in the Tampa Bay, Florida, area, told WFLA-TV she has cared for upwards of seven patients at a time and believes staffing shortages are impacting patient safety.

“How would you feel if your sister or brother or your husband or your wife or your child goes into a facility, and they’re like, ’I’m sorry, they acquired an infection here and the real reason is we couldn’t change that dressing in time because we didn’t have enough staff?’” she told the TV station.

And nurses at Florida’s James A. Haley Veterans’ Hospital were among the 160 workers who recently held a rally in opposition to what they believe is a hiring freeze, the “Tampa Bay Times” reported. 

One nurse who spoke to the newspaper said the staffing shortages are putting patients at risk. However, hospital officials dispute the nurses’ stance, citing consistent growth and more than 100 nurses in “some stage of the hiring process.” 

In New York, two senior officials at a VA facility were removed in connection with concerns about delayed care, WKBW reported. 

“When you have less nurses and more patients…it’s a simple equation, there’s going to be negative consequences,” Katie Donovan, communication chair for National Nurses United, told the outlet. 

On the other side of the country, Arrowhead Regional Medical Center (ARMC) nurses reported more 125 incidents of “unsafe patient care due to a lack of sufficient staff” at their California facility, according to IE Community News.  

“Before the pandemic, we could get our ventilated patients up for walks. Now, due to staffing issues, our patients are weakening day-by-day as we don’t have the staff or resources, making it tougher to rehabilitate them,” Diana Lucatero, an RN who works in ARMC’s medical intensive care unit, told IE Community News. 

US Research Supports UK Study 

Studies conducted stateside years before the United Kingdom study support their findings. One of them, published in 2021, looked at patient-to-nurse staffing ratios in Illinois hospitals and discovered that if nurses in medical-surgical units cared for “no more than four patients each, thousands of deaths could be avoided.” 

In touting the importance of safe staffing ratios, the New York Nurses Association cited several agencies and medical journals that argue better ratios result in improved patient care and fewer deaths, among other benefits. 

The Bottom Line

A new study published in JAMA Network Open investigated the relationship between the risk of patient death and nurse staffing levels. The study authors found that the lower the staffing, the higher the likelihood of death. They also believe their findings challenge the idea that temporary staff are a “cost-effective, long-term solution” to maintain patient safety. The study comes out as nurses across the United States have been sharing their concerns about low staffing levels and the quality of patient care. 

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