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6 Working Nurse l WorkingNurse.com August 12–September 16, 2019 ON THE QUICK Nursing & Healthcare News Do BSNs Save Lives? Study shows better outcomes, but adequate staffing still a must T here's yet more research linking a hospital's percentage of BSN-prepared nurses with better outcomes for in-hospital cardiac arrest patients. Recognize and Respond In-hospital cardiac arrest is a severe test for any care team. Inpatients who have heart attacks are usually elderly, often with comorbid conditions that complicate resuscitation. Quick response is essential to keep arrest patients alive and avoid neurological impairment, but many arrests occur during off hours, when staffing levels are lowest. In these tough situations, says a new study in Health Affairs, having a better-educated nursing staff makes a real difference. The authors examined data for more than 11,000 patients at 36 hospitals in four states (including California) and found that having more BSN-prepared nurses significantly improved patient outcomes. A 10-percentage-point increase in a hospital's number of BSN-prepared nurses improved arrest patients' odds of surviv- ing to discharge without cerebral impairment by 24 percent. Lead author Jordan Harrison, RN, Ph.D., attributes the differ- ence to the better-educated nurses' ability "to recognize patient deterioration before cardiac arrest, along with effective response once an arrest has happened." Patient Load However, even with a well-educated nursing staff, cardiac arrest patients' chances of surviving to discharge (with or with- out impairment) remained poor — overall survival rate was only 18.3 percent — and having more BSN-prepared nurses didn't significantly change that. What did improve patients' chances was better staffing. Reducing the average nurse-to-patient ratio by one patient per nurse translated into a 16 percent improvement in arrest patients' odds of surviving to discharge. WN Patient Handling Injuries California law has helped, but better staffing may be needed I t's now been almost five years since California implemented statewide standards for safer patient handling. New research shows that there's still room for improvement. Assessing the Regulations Implemented in October 2014, California's safe patient handling regulations have required hospitals to introduce additional equipment, procedures and training to help staff move patients with less risk of injury. The big question: Has it helped? UCSF researcher Soo-Jeong Lee, RN, Ph.D., ANP, has spent years studying workplace injuries among healthcare workers. To assess the impact of the California law, she and her colleagues surveyed nurses in 2013 and 2016, both before and after the Cal/OSHA safe patient handling regulations took effect. The results, published earlier this year in the American Journal of Industrial Medicine, suggest that the law has had some positive effects, albeit less dramatic than proponents may have hoped. Technology Only a Partial Fix The authors found that the regulations have brought about some important changes: more training, more powered lifts and better lift availability. The results also show some modest but significant decreases in certain types of serious musculoskeletal injuries. However, only 30.3 percent of 2016 respondents believed that those changes had made patient handling less risky for nurses. More than a third (35.8 percent) said their risk has actually increased since the enactment of the regulations. Technology has proven to be only a partial fix. While powered lift devices have become more widely available, they still aren't widely used. Almost half (46.8 percent) of 2016 respondents said they use lifts less than 25 percent of the time, perhaps because it's often too distracting or time-consuming. "It isn't easy to wait," Lee concedes. Lee believes that additional staffing might make a bigger difference, helping to ensure that there's enough staff avail- able to provide lifting support for nurses who need it, when they need it. WN For direct links to the websites cited, find these articles at WorkingNurse.com