Nurse Staffing Costs Must Be Weighed Against Cost of Errors

Rebecca Hendren, for HealthLeaders Media , August 30, 2011

"When hospital executives tell me there's not enough money to staff well, my first thought is 'what about the $21 billion we spend each year on unreimbursed never events?'"

Douglas believes the answers lie in using data and evidence to make effective decisions and utilizing technology in decision making. She is not a fan of blanket ratios.

"It's not that ratios are bad in and of themselves. Ratios happened, in my opinion, because hospital leadership and nursing weren't communicating well," she says. "My issue with ratios is that it assumes [staffing] is about a number. I disagree with that. It's not about a number. It's about the right number with the right qualifications with the right competencies with the right experiences."

Douglas says hospitals need to be free to examine all the factors and design a system that is flexible and allows flexing up and down based on patient needs and professional nurses' best judgment.

To do so, we need a better understanding of what the research shows about nurse staffing. We also need nurses who understand how they contribute to overall performance and who are accountable for that role.

Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits and manages The Leaders' Lounge blog for nurse managers. Email her at
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14 comments on "Nurse Staffing Costs Must Be Weighed Against Cost of Errors"

Mark (9/16/2011 at 4:59 PM)
"To do so, we need a better understanding of what the research shows about nurse staffing." The research continues to show that under staffing leads to errors, increases in infection rates and marginal care. What "better" understanding is it that we need? The need to "flex up" will only work in the unpredictable world of hospital nursing when the flex nurse is available immediately. Too often there's no one at all to do the flexing and the nurses are left runnig around like headless chikens, praying that no pt. will be harmed by shift's end.

Mike (9/14/2011 at 9:36 PM)
Bonnie, there was no mention of the staff being under educated. I believe the issue at hand was the lack of sufficient staffing, which, in turn, causes the remaining staff to be overbudened. Thus the errors and burnout.

Bonnie (9/7/2011 at 5:22 PM)
I agree that nurse staffing does effect issues such as infections, falls, med errors, etc. However far more than that, continued education and updating nurses on best practise does work. Include nurses in the quality one on one education of their peers has proven to be far more effective than online training. Involving the new grads in a concentrated quality education is very effective in preventing safety issues.




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