Washington, D.C.-based George Washington University and Premier researchers found overreliance on agency nurses and nurse overtime was associated with lower patient safety.
The study, published April 2 in JAMA Network Open, analyzed data on quality measures for pressure ulcers and nurse staff overtime and agency use from 70 U.S. hospitals from January 2019 through December 2022.
Researchers found that nearly half of the hospitals in the study utilized more nurse overtime and agency hours than was safe.
The average hours exceeding safe thresholds for agency staff reached 140% and 63.6% for nurse overtime. Overuse of agency nurses and overtime hours was associated with increased rates of pressure ulcers. More agency hours are also associated with more post-surgery hemorrhage or hematoma rates.
Although researchers recognized that hospitals have a valid need to schedule overtime and use agency nurses in some cases, they said that too much reliance on these solutions, especially on travel nurses, could lead to potential patient harm.
“Our study shows that when hospitals over rely on travel nurses or overtime for the regular nursing staff, patient safety care may be compromised,” Patricia Pittman, PhD, lead author of the study and director of the Fitzhugh Mullan Institute for Health Workforce Equity at the GW Milken Institute School of Public Health, said in an April 2 news release. “Hospitals that want to improve safety should closely track their reliance on overtime and especially nurse staffing agencies.”
