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Agency for Healthcare Research Quality

Health Care Workforce

Nursing shortage may have adverse impact on public health emergency preparedness

A robust nursing workforce is needed for a hospital to effectively respond to a public health emergency (PHE) such as a terrorist attack, infectious disease epidemic, or natural disaster. The shortage of nurses looming in the long run presents a challenge to public health preparedness and, thus far, has not been addressed by a comprehensive national strategy, according to Matthew D. McHugh, Ph.D., of the University of Pennsylvania. In a recent review of the topic, he argues for a national commitment to nursing education and workforce infrastructure to ensure emergency preparedness in the United States.

Surge capacity is the health care system's ability to quickly expand beyond normal services to meet the increased demand for medical care in the event of bioterrorism or other large-scale PHE. Nurses are an integral part of disaster response. They are needed to staff surge beds, triage patients, and administer medications and emergency-related vaccines. However, nurse staffing and supporting systems are weak links in the emergency preparedness chain. In many cases, hospitals have little flexibility for unanticipated fluctuations in patient acuity and demand on a daily basis, and an absence of standby nursing capacity for large-scale emergencies.

In order to address the looming shortage of nurses, keep pace with demand, and maintain emergency preparedness, it is estimated that nursing schools need to graduate 25 percent more nurses each year. However, insufficient nursing faculty, inadequate financial resources, limited physical capacity, and insufficient clinical education sites mean that schools today cannot produce this number of nurses. Hospitals will need the support of a federally funded, comprehensive program, asserts the author. This program will have to emphasize long-term investments in the U.S. nursing profession through expanding nursing faculty and schools, boosting incentives for the nursing profession and nursing education, and increasing incentives to hospitals with favorable nursing practice environments, clinical training sites, and adequate nursing surge capacity. This review was supported by the Agency for Healthcare Research and Quality (HS17551).

See "Hospital nurse staffing and public health emergency preparedness: Implications for policy," by Dr. McHugh, in the September 2010 Public Health Nursing 27(5), pp. 442-449.

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