Healthcare Cost Containment

February 1, 2013

Temporary Nurse Staffing: Taking a Closer Look

By Karen Wagner

Many hospitals use temporary nurses to some extent. Indeed, two-thirds of hospital executives participating in a recent study reported using travel or per diem nurses, according to KPMG's 2011 Hospital Nursing Labor Study, which was comissioned by the National Association of Travel Healthcare Organizations (NATHO).

However, typically as little as 3 percent of hospital nurse staffing is temporary, says Mark Stagen, NATHO founder and CEO of Emerald Health Services, a staffing firm based in Marina del Rey, Calif.

"Health care does not incorporate the idea of temporary labor into their business model as aggressively as other industries do," Stagen says. He suggests that it makes sense for hospitals, as seasonal, census-driven organizations, to reassess the untapped potential offered by temporary nurse staffing.

Impact on Quality
In the past, concerns about quality of patient care led many hospitals to be wary of temporary nurse staffing, on the premise that nurses who are less familiar with a hospital's or unit's practices and procedures could inadvertently contribute to an increase in the rate of adverse events, such as patient falls or medication errors. Nurse leaders also have questioned whether use of temporary nurse staffing could detract from continuity of care and team communication, thereby affecting patient outcomes. After analyzing data about 1.3 million patients and 40,000 nurses at more than 600 hospitals, researches from the University of Pennsylvania School of Nursing concluded that these concerns are unfounded.
 The study's lead author, Linda Aiken, PhD, RN, a professor of nursing and sociology and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania, says that research supports prudent use of travel nurses as a supplemental staffing strategy. "What we find in our research is that almost all hospitals in America. Most magnet hospitals, which have been accredited for their excellence in nursing, use agency nurses," Aiken says.