Nurse Staffing Levels Linked to Patient Satisfaction With Pain Management

Hospitals with more nurses on staff and better nurse-patient communication tend to receive higher scores on patients’ satisfaction with pain management, according to new research.

The study, published online in Pain Management Nursing, analyzed results from the Hospital Consumer Assessment of Health Care Providers Systems survey from hospitals in California, Massachusetts, and New York. It examined the associations between patient perceptions of pain control and hospital staffing numbers of nurses, hospitalists, physicians, and residents. It also studied 21 other hospital-level factors that were correlated with patients’ pain management reports.

Patients’ perception of pain control improved significantly with increasing numbers of registered nurses, nursing staff, and hospitalists, but worsened with higher numbers of residents or interns. Additionally, both higher numbers of nursing staff and being treated in a nonprofit hospital decreased the likelihood of patients reporting their pain was poorly managed.

There were also several factors that made patients significantly more likely to report their pain was poorly controlled: they did not receive help as soon as they wanted, poor nurse communication, poor medication education, and being treated in a teaching hospital. Patients reported particularly low rates of pain control satisfaction if they were treated in teaching hospitals with rotating intern/resident assignments.

The researchers also determined that 79% of the variations in self-reports of pain control could be explained by just 6 predictors. Nurse staffing and nurse-patient communication were the strongest predictors of pain management perceptions among patients.

“The findings highlight the need for adequate numbers of nursing staff to achieve optimal patient satisfaction with pain management,” said lead author Judith Shindul-Rothschild, PhD, MSN, RN, in a news release from Boston College. “In addition, having a prescriber (physician or nurse practitioner) available 24/7 to offer continuity of care is essential.”

The results also point to the importance of strong communication among providers and patients in making sure that patients feel their pain needs are well managed.

“In addition to appropriate nurse staffing, our study highlights that an essential component to improve patients' satisfaction with pain management is to promote more effective collaboration among medical trainees, hospitalists, and nurses,” Shindul-Rothschild said.