nurse staffing shortages may
have significant implications
for quality of patient care

A nursing shortage may have serious implications for the quality of patient care. A recent HRSA study found a relationship between higher RN staffing levels and the reduction of certain negative hospital inpatient outcomes, such as urinary tract infection and pneumonia.

Furthermore, a recent Health Care Financing Administration (HCFA) report to Congress found a direct relationship between nurse staffing levels in nursing homes and the quality of resident care. HCFAs analysis of three states data demonstrated that, after controlling for case mix, there is a minimum nurse staffing threshold below which quality of care may be seriously impaired.

However, 23 percent of the facilities in the three states were not staffing at the combined RN and LPN minimum staffing threshold level, and 31 percent of the facilities were not staffing at the RN minimum staffing threshold level.

The Nursing Shortage Is Likely to Worsen

The nursing shortage is expected to worsen in the future, with pressures expected on both demand and supply.

The future demand for nurses is expected to increase dramatically when the baby boomers reach their 60s, 70s, and beyond. The population aged 65 years and older will double from 2000 to 2030. Moreover, the population aged 85 and older is the fastest growing age group in the U.S.

At the same time, the number of persons who have traditionally worked in the nursing workforcewomen between 25 and 54 years of age is expected to remain relatively unchanged over the period from 2000 to 2030.

Over the past decade, the nurse workforces average age has climbed steadily, while fewer young persons are choosing to enter the nursing profession. The average age of the RN population in 2000 was 45, almost 1 year older than the average in 1996.

Phase II of the HCFA Study is currently under way to analyze additional states data to identify alternative minimum thresholds and optimal case-mix adjusters and to assess relative costs and benefits of such thresholds.

According to HCFA officials, more research will be required to assess the feasibility of implementing minimum ratio requirements.

Other facts about nursing staff shortages

Few men currently work in nursing. As of 2000, only 5.9 percent of RNs employed in nursing were men.fewer than one in three were younger than 40 in 2000. During the same period, the percentage of nurses under age 30 dropped from 25 to 9 percent. the age distribution of RNs has shifted dramatically upward.

The number of nurses aged 25 to 29 decreased from about 296,000 in 1980 to about 177,000 in 2000, while the number aged 45 to 49 grew from about 153,000 to about 465,000.

The total number of licensed RNs increased 5.4 percent between 1996 and 2000 the lowest increase ever reported in HRSAs periodic survey of RNs.

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