20.08.14
Nurse staffing levels linked to stroke mortality rates
Fewer nurses on hospital wards at weekends have been associated with higher mortality rates for stoke patients.
The research – Staffing of Healthcare Workers and Patient Mortality: Randomized Trials Needed – found that the frequency of doctors' ward rounds was not associated with a difference in mortality. However, the presence of a higher number of nurses per 10 beds was associated with reduced mortality.
Researchers found that patients admitted on a weekend to a stroke unit with 1.5 nurses per ten beds had a 30-day mortality risk of 15.2%, whereas patients admitted to a unit with three nurses per ten beds had a mortality risk of 11.2%. This equates to a mortality risk difference equivalent to one excess death per 25 admissions, the researchers said.
Dr Benjamin Bray of King's College London, who led the research, said: “I would suggest the role of stroke doctors is still very important but the risk of death is the wrong thing to measure when considering their impact.
“We found a strong relationship between the number of nurses working on a weekend and the risk of a patient dying after a stroke.
“It is up to individual hospitals to review their staffing levels and for policy makers to look at this sort of evidence and point to what they think would be minimum levels of nurses.”
The study was based on the clinical data of 56,666 patients who were admitted to stroke units in England over an 18-month period from a national stroke register, the information on the characteristics and staffing levels of the stroke units from a biennial survey of hospitals admitting patients with stroke, and information on deaths among patients with stroke from the national register of deaths.
Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “This is further evidence of the vital importance of having proper nurse staffing levels to ensure good patient care.
“The number of registered nurses on a ward is strongly linked to stroke patients’ outcomes. If a hospital has enough nurses in place, stroke patients are more likely to survive and to recover. It is unacceptable that stroke patient mortality rates are higher at weekends when staffing levels tend to be lower.”
He added that the findings reinforce what is already known – “only with the right number of nurses, with the right skills, can we ensure patients are properly looked after with dignity and compassion”.
Nikki Hill, deputy director of external affairs at the Stroke Association, added that nurses are a vital part of the specialist stroke team, helping more people survive and thrive after stroke.
A spokesman for NHS England stated that the NHS is committed to providing staffing levels that can deliver high quality care - hospitals should use the evidence to set staffing levels that meet the needs of their patients.
He said: “The number of staff on wards is now reported monthly on the NHS Choices website and boards publicly examine staffing levels regularly. But it is not just about numbers. Leadership and culture is vitally important to ensure staff work in the right environment to deliver the best possible care for patients.”
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