News: Better sepsis outcomes connected to more RN hours, study finds

In a study of 702,140 Medicare beneficiaries in 2018, researchers from the Journal of the American Medical Association (JAMA) Health Forum confirmed a statistically significant link between patients with a primary diagnosis of sepsis on admission and hours of nursing care. They estimated 1,266 fewer of the 182,346 deaths would have occurred if all hospitals added six more RN hours per patient day, and 6,360 fewer deaths if nine more RN hours per patient day were added. The researchers concluded that each hour increase of RN hours per patient day was associated with a 3% decrease in mortality likelihood at 60 days, MedPage Today reported.

Having an on-staff intensivist at the 1,958 acute care hospitals studied was also statistically significant—associated with a 16% decrease in sepsis mortality at 60 days. On the other hand, having more hospitalist and physician hours was linked with a higher sepsis mortality. This discrepancy could be a result of the likelihood that nurses will report to one group of physicians over another (e.g., intensivists over physicians), the researchers hypothesized. They suggested that it also highlights the importance of interprofessional communication between all clinicians.

The SEP-1 measure itself was analyzed as well. SEP-1 gauges a facility’s ability to treat sepsis in a timely manner and effectively, though it has had controversy over requirements and timelines. Still, the JAMA researchers found that a 10% increase in a facility’s SEP-1 score was associated with 2% less likelihood of sepsis mortality at 60 days, and a facility well-staffed with nurses would likely see an improvement in SEP-1 bundle compliance.

Generally, the researchers attributed these results to the fact that the workload of nurses impedes the rapid initiation of antibiotic treatment for sepsis patients. Though these findings were drawn from 2018 data, they argued it is even more relevant to hospitals post-pandemic, as staffing shortages continue to threaten patient safety.

Editor’s Note: To read MedPage Today’s coverage of this study, click here. To read the full study in JAMA, click here.