Patients who stay on hospital wards that are not properly staffed with nurses are more likely to die or be readmitted, a new study has claimed.
The journal BMJ Quality & Safety has this week published a study into the impact of poor registered nurse or healthcare assistant staffing in hospitals.
“Using agency staff to eliminate understaffing is less cost-effective and would save fewer lives than using permanent members of staff”
BMJ study
It analysed patient and staffing rosters across 185 acute healthcare wards in four English NHS trusts between April 2015 and March 2020.
Researchers, led by Dr Christina Saville of the University of Southampton’s School of Health Sciences, found that patients on wards that were understaffed by registered nurses were one percentage point more likely to die than those on wards where this was not the case.
As well as this, 15% of patients on the understaffed wards were readmitted, compared to 14% on well staffed wards, and patients were more likely to stay in hospital for longer.
Patients on wards with too few registered nurses also experienced, on average, less care time; they had an average care shortfall of one hour and nine minutes per day in the first five days.
Each day a patient spent on a ward with below-average registered nurse staffing, the report found, increased the risk of death and readmission.
The study found “similar figures” for wards understaffed by nursing support staff, with the exception of readmission risk.
It asserted that eliminating understaffing was both good for patients and made economical sense.
Researchers calculated that the extra costs of eliminating understaffing, through the use of permanent staff, would be outweighed by the savings of shorter hospital stays.
Meanwhile, they asserted that using agency staff to fill the staffing needs would cost up to more than three times as much.
“Using agency staff to eliminate understaffing is less cost-effective and would save fewer lives than using permanent members of staff,” the study said.
Further, it found evidence that targeting entire wards – instead of specific patient groups – was both more effective and more cost-effective.
The reseachers concluded: “When considering alternative policy strategies, this study indicates the importance of prioritising investment in [registered nurses] employed on wards over support staff, as well as showing there are no shortcuts to employing enough [registered nurses], as using temporary staff is more costly and less effective.”
Following the publication of the study, chief nursing officer for the Royal College of Nursing, Lynn Woolsey, said it was “yet more evidence of the clear link between nurse shortages and patient mortality”.
Ms Woolsey added: “Ministers need to recognise that investment in nursing more than pays for itself, improving patient safety and the health of the population.
“Our profession is in a unique position to help people live longer, healthier lives and save money for the NHS and government.
“As student recruitment collapses and the numbers quitting nursing rises, new funding to boost recruitment and retention couldn’t be more urgent.”
