A study published in Medical Care found that lower patient-to-nurse ratios in medical-surgical units are associated with better patient survival after in-hospital cardiac arrest. With each added patient per nurse, survival dropped 5%. The research, based on 11,160 cases from 75 hospitals, also found that poor hospital work environments are associated with lower survival after in-hospital cardiac arrest.
An analysis of data on 11,160 patients found that nurse staffing in medical-surgical units and better scores on a measure of nurses' work environments were associated with increased survival rates for in-hospital cardiac arrest. No correlation was found between survival rates and staffing ratios in ICUs, possibly because there are national standards for staffing intensive care, said researcher Monica Rochman of the University of Pennsylvania School of Nursing. The study included 2005-2007 data from 75 hospitals, and findings were presented at a meeting of the American Association of Critical-Care Nurses.
Data from the American Heart Association's Get With the Guidelines program showed patients who have strokes outside of a hospital setting get better care and have better outcomes than those who have the attacks as inpatients, according to research presented at the Society of Hospital Medicine conference. Dr. Ethan Cumbler, program director of the National Stroke Association In-Hospital Stroke Quality Improvement Initiative, said in-hospital strokes should be reported to quality databases so "we can accurately understand the quality of care we are providing, identify gaps, and perform process improvement to close any discrepancies."
Patients suffering from heart failure receive palliative care consultations only late in their illness, according to a study of 1,320 patients in the Journal of Cardiac Failure. Although the Seattle Heart Failure Model predicted a median one-year survival rate for most of the patients receiving the consultations, the actual survival time from consultation to death was a "remarkably short" 21 days. "This suggests that this cohort was identified by their clinician for PCC when they were acutely and seriously medically ill and in their later stages of dying," the research team wrote.
An American Heart Association consensus statement said survival rates for in-hospital cardiac arrest need to improve, and it should not be assumed that gains made in out-of-hospital care are directly applicable to inpatients. The statement, published in AHA's journal Circulation, said hospital culture and best practices should be addressed and in-hospital cardiac arrest reporting should be improved.