Researchers have managed to establish a connection between patient deaths and hospital staff. According to their investigations, death rates in English hospitals where registered nurses were assigned to six or fewer patients were 20 percent lower as compared to those where each nurse cared for at least 10 patients. This highlights the importance of concentrated attention of nursing staff for patient care and recovery.
The findings were published in the online journal BMJ Open.
Outline of the Study
Researchers considered 137 acute care trusts and assessed the number of beds per registered doctor, nurse and healthcare support worker between 2009 and 2011. They also analyzed data regarding 2,917 registered nurses from a nationally representative subsample of 31 of the trusts and looked into the number of patients assigned to each ward nurse.
The number of predicted deaths among surgical and medical inpatients was then calculated, keeping in check various confounding factors including age, underlying aspects and the number of emergency admissions in the last 12 months.
Patient Deaths In UK: Analyzing And Deciphering Data
Out of the 137 trust hospitals analyzed, the number of surgical and medical admissions recorded for the two year time period was 9,302,292 and 9,669,555 respectively. Moreover, the overall death rates from surgical and medical admissions were 7.9/1000 and 32.8/1000 respectively. Evaluation of the subsample of 31 trusts revealed a rate of 35.2/1000 deaths from medical admissions (from a total of 1,260,558) and a rate of 8.9/1000 deaths from surgical admissions (from a total of 1,084,429).
A significant variation was seen among the trusts in terms of their registered nurses, with a fourfold difference between those at the bottom and at the top of the scaling staff. Trusts where a single nurse cared for an average of six or less patients in medical wards showed a 20 percent lower mortality rate as opposed to trusts where a nurse was assigned more than 10 patients. Similar statistics were obtained for surgical wards, where a higher nurse to patient ratio was linked with a 17 percent decrease in impatient death rates.
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Moreover, for patients admitted to medical wards, increased number of deaths were linked to the higher number of occupied beds that each registered nurse and doctor had to care for. However, a higher number of healthcare support workers were associated with higher rates of inpatient mortality. Including all staff members and adjusting for mortality showed statistically significant associations for doctors and healthcare workers, but not for nurses.
Possible Limitations of the Study
Despite the comprehensive analysis, researchers acknowledge that the study did have potential limitations. They stated that the research design was a ‘cross sectional observational study’ and thus cannot be used to establish or conclude causation. Also, data on ward staffing was obtained from only 31 trusts, which cannot be generalized to the entire healthcare scenario.
“When evaluating the efficacy of nursing staff in hospital wards, the number of registered nurses is crucial. There is no evidence to suggest that higher levels of healthcare support worker staffing could potentially play a role in reducing the rates of inpatient mortality. Furthermore, current policies geared towards substituting such healthcare workers for registered nurses should be reviewed in the light of this evidence”, concluded the authors of the study.
Forming A Conclusion
Nursing is generally among the most common healthcare profession, majorly outnumbering physicians in various countries. Nurses play a vital role in providing healthcare services not only in conventional settings such as hospitals and long-term healthcare facilities, but also in primary care and home-based settings for the chronically ill.
Despite certain anomalies in the research design, the fact that nurses play an integral role in providing personalized healthcare to patients cannot be undermined. Keeping in mind this fact, certain countries have developed more advanced roles for nurses to compensate for the shortages of doctors.
Assessing the current roles assigned to nurses in the UK, the US and Canada have demonstrated that advanced nursing practices significantly improve access to healthcare services, reduces waiting time and delivers superior quality care to chronically ill, routine and follow-up patients. Moreover, these evaluations also highlight high patient satisfaction and reduction in costs.
Hence, the implementation of advanced nursing roles must be given priority in healthcare settings to improve patient recovery and monitoring. This may require the modification of existing legislations and regulations to overcome potential barriers.