The modest use of temporary or contract nurses is a cost-efficient strategy during temporary periods of patient census swings or short-term shortages of permanent nurses at large US medical centers. This is according to a new study by researchers at the University of Rochester School of Nursing, the American Staffing Association announced. The study also found hourly personnel costs for supplemental nurses efficiently offset the overtime costs of permanent nurses.

“Prior research has shown that temporary and contract nurses are just as qualified —through education and experience — as permanent nurses,” said Richard Wahlquist, president and CEO of the American Staffing Association. “This study shows that supplemental nurses offer the strategic flexibility that hospitals need to augment their workforces during peak times, and to address any interim labor shortages related to leave coverage, vacancies, and expansion of services.”

The use of agency-employed supplemental nurses on nursing personnel costs was examined in 19 adult patient care units in a large academic medical center. Results indicated modest use of supplemental nurses was cost-efficient with regard to overall nursing personnel costs, but heavy reliance on supplemental nurses to meet staffing needs was not cost-efficient. In addition, there was no statistical difference in hourly personnel cost between the use of supplemental nurses and overtime worked by permanent nurses.

• Compared with no use of supplemental RNs (use of only permanent RNs), when use of supplemental RNs was more than 0 and 0.2 or less hours per patient-day, the average overall nursing personnel cost per patient-day decreased by $6.03.
• When the use of supplemental RNs was more than 0.2 and 0.4 or less hours per patient-day, the average nursing personnel cost per patient-day was $2.47 more, which was not significantly different from no use of supplemental RNs.
• Compared with no use of supplemental RNs, use of supplemental RNs at levels above 0.4 hours per patient-day was associated with significant increases in overall nursing personnel costs.

“In addition to not being cost-effective, overtime hours performed by permanent nurses may equate to poor nurse and patient satisfaction,” said researcher Linda Aiken, with the Center for Health Outcomes and Policy Research, University Pennsylvania. “Extensive research indicates that overtime work is connected to nurse burnout, turnover, and poor patient outcomes. The use of supplemental nurses can alleviate these risks.”

Published in the April–June issue of the Journal of Nursing Care Quality, the study, “Cost Outcomes of Supplemental Nurse Staffing in a Large Medical Center: A Method for Quantifying Supplemental Nurse Cost Efficiency,” analyzed hospital nursing personnel cost data collected from a large medical center in upstate New York between July 2003 and December 2006. The data included all patient stays (465,936) in 19 varied adult patient care units. This study is the first to use longitudinal hospital unit-level data to investigate the cost and cost efficiency of using supplemental nurses.