April 8, 2025 Story by: Editor
A new study – just published in Nursing Research – has uncovered concerning disparities in patient outcomes, specifically related to nursing care, within hospitals that predominantly serve Black communities. The research, which analyzed data from over 3,000 hospitals across the United States, reveals that these Black-serving hospitals (BSHs) exhibit significantly higher rates of specific adverse patient events.
We observed a clear trend. Hospitals serving a higher proportion of Black patients demonstrated significantly elevated rates of pressure ulcers, postoperative sepsis, and perioperative pulmonary embolus/deep vein thrombosis.”
Eileen T. Lake, PhD, RN, FAAN, lead-author, the Edith Clemmer Steinbright Professor in Gerontology; Professor of Nursing in the Department of Biobehavioral Health Sciences; and Associate Director of CHOPR
The study from Penn Nursing’s Center for Health Outcomes and Policy Research (CHOPR), utilizing data from 2019 to 2022, examined four key nursing-sensitive indicators: pressure ulcers, perioperative pulmonary embolus/deep vein thrombosis, postoperative sepsis, and “failure to rescue,” which refers to death following serious surgical complications. These distressing, uncomfortable, or grave conditions are directly influenced by nursing care. Their occurrence can affect a patient’s ability to go home, their comfort during recovery, and their overall healing process. Researchers categorized hospitals into high, medium, and low BSHs based on the percentage of Black patients they served.
The findings painted a stark picture. While the overall average rates for these indicators were 0.59 for pressure ulcers, 3.38 for perioperative pulmonary embolus/deep vein thrombosis, 4.12 for sepsis, and 143.58 for failure to rescue, the study revealed a significant divergence when comparing BSH categories.
“We observed a clear trend,” said lead-author Eileen T. Lake, PhD, RN, FAAN, the Edith Clemmer Steinbright Professor in Gerontology; Professor of Nursing in the Department of Biobehavioral Health Sciences; and Associate Director of CHOPR. “Hospitals serving a higher proportion of Black patients demonstrated significantly elevated rates of pressure ulcers, postoperative sepsis, and perioperative pulmonary embolus/deep vein thrombosis.” The failure-to-rescue rates did not show significant differences across the BSH categories.
The study, encompassing 3,101 predominantly urban, non-teaching hospitals, also revealed a paradox: BSHs were more likely to have Magnet designation, a recognition of nursing excellence, than other hospitals (14% vs. 12%). This suggests that despite potential strengths in nursing infrastructure, patient outcomes remain compromised in BSHs.
These findings underscore the urgent need to address systemic factors contributing to these disparities. Further research is crucial to understand the underlying mechanisms, particularly the relationship between nursing resources, such as staffing and the work environment, and patient outcomes in these hospitals. The researchers emphasized that the poorer nursing-sensitive indicators observed in high BSHs and previously documented poorer nurse staffing necessitate immediate policy and management interventions.
Co-authors include Celsea Tibbitt, PhD, RN, John F. Rizzo MSN, CRNP, FNP-BC, and Christin Iroegbu, PhD, RN, all Postdoctoral Fellows (Tibbitt; Iroegbu) or former Predoctoral Fellow (Rizzo) at the University of Pennsylvania; Jessica G. Smith, PhD, RN, Associate Professor at the University of Texas at Arlington; Douglas O. Staiger, PhD, John Sloan Dickey Third Century Professor at Dartmouth College; and Jeannette A. Rogowski, PhD, Professor at The Pennsylvania State University. The research was supported by a grant of T32NR007104 from the National Institutes of Health.
