The cost of nurse-sensitive adverse events

Area of Science:

• Healthcare Management
• Nursing Economics
• Patient Safety

Background:

• Healthcare leaders increasingly focus on optimizing nurse staffing effectiveness due to transparency in quality and cost outcomes.
• Hospitals utilize cost accounting systems to track patient-level direct costs, enabling analysis of expenses during a hospital stay.
• Understanding the cost of complications allows justification of improved nurse staffing when evidence links it to better quality outcomes.

Purpose of the Study:

• To describe a methodology for nursing leaders to determine the cost of adverse events.
• To establish effective nurse staffing levels based on cost-benefit analysis.

Main Methods:

• Analysis of financial and clinical data from hospital databases for 3,200 inpatients.
• Development of a methodology to calculate actual cost per case.
• Focus on three diagnosis-related groups and analysis of five adverse events and their associated costs.

Main Results:

• The direct cost of an adverse event was $1,029 per case in congestive heart failure and $903 in surgical cases.
• Significant cost increases were observed in medical patients with urinary tract infections and pressure ulcers, and surgical patients with urinary tract infections and pneumonia.
• Increased registered nurse hours per patient day were associated with decreased odds of pneumonia in surgical patients.

Conclusions:

• Hospital cost accounting systems are valuable tools for determining adverse event costs and informing nurse staffing decisions.
• Adverse events increase patient care costs; unit-level measurement is crucial for adjusting staffing to reduce these events and associated expenses.