It’s a question long in need of an answer. Is the use of temporary nurses a cost-effective staffing solution for hospitals looking for ways to optimize their human resources and ultimately, quality of care? The University of Rochester, School of Nursing, took on the question and analyzed the cost-effectiveness of agency-employed supplemental nurses in 19 adult patient-care units of a large, academic medical center.
As might be expected, the results were mixed depending on the volume of supplemental nurses needed to optimize staffing. Minimal use of temporary nurses resulted in slightly lower overall costs when compared to permanent nurse overtime costs. Moderate use of supplemental nursing resulted in slightly higher overall costs and heavy use demonstrated significantly higher costs. The final conclusion of the study is that minimal to moderate use of temporary and travel nurses, cost about the same as permanent nurses working overtime.
Researcher Linda Aiken, Center for Health Outcomes and Policy Research, University Pennsylvania explains, “In addition to not being cost-effective, overtime hours performed by permanent nurses may equate to poor nurse and patient satisfaction. Extensive research indicates that overtime work is connected to nurse burnout, turnover, and poor patient outcomes. The use of supplemental nurses can alleviate these risks.”
75% of Hospitals use Temporary Nurses
With more than half of U.S. hospitals using temporary and travel nurses to alleviate staff shortages, it’s important to understand their effectiveness. In addition to cost-effectiveness, a study reported in the March 2015 edition of Journal of Nursing Administration suggests that the use of temporary nurses has no impact on patient satisfaction either positive or negative. This may be due to further evidence that supplemental nurses have equivalent educational qualifications as most permanent nurses which is a contributing factor to positive patient outcomes.
As a result of these studies, the key to optimizing hospital nursing staff is to have sufficient permanent personnel to manage core patient load and to add temporary or travel nurses to shore up short-term deficits. Of course, this objective is easier to say than to put into practice. Every hospital experiences fluctuations in patient census, employee resignations, increases in patient acuity, and temporary leave of absences leaving some to ask, “How can we optimize healthcare staffing with all of these variables in play?”
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