What is the ratio of patients to nurses in your workplace and how effective was it in terms of providing quality nursing care?
In recent studies, it was identified that staffing availability has been closely linked to how nurses operate and responded in terms of providing quality nursing care to patients.
Setting aside the skill level of each nurse involved, the evidence had led to a conclusion that the number of staff allocated in a facility was associated with the institutions death rates, the length of hospital stay of each patient, and the improvement of the patient condition according to the intensity of each patient case.
In connection to this statistic, a research was conducted by the University of Southampton which showed that there were lesser mortality rates within facilities that have more doctors and nurses on duty to provide immediate care during critical patient situations. The said study was published by the British Journal of Anaesthesia where 295,000 patients were examined in the aim to point out the disparities in death rates following an emergency surgery in different healthcare institutions with different staffing levels.
More medical staff equates to higher patient survival rates
…the study identified a direct link between the nurse and doctor to patient ratio with the patient’s survival rate.
Apparently, the study identified a direct link between the nurse and doctor to patient ratio with the patient’s survival rate. It began to suggest a deeper connection to the quality of medical management provided between understaffed facilities and those that have enough medical workers, especially during and after any emergency situation.
The researchers examined an approximate 300,000 cases of emergency general surgeries at 156 NHS Trusts over a five year period where mortality rates were then linked to a variety of complications arising during and after the medical situation that was plausibly caused from facility staffing. The study had collected the death rates within 30 days after a patient admission.
It was noted that 14 NHS Trusts were significantly higher in mortality rates while nine NHS Trusts had lower patient loss rates.
…institutions that lacked the needed medical staff had higher than expected death rates
According to the researchers, the provision of more nurses, consultants, surgical junior doctors, available critical care beds, and operating theatres had yielded lower mortality rates for the Trusts facilities with emergency general surgery procedures. Consequently, institutions that lacked the needed medical staff had higher than expected death rates.
Mike Grocott, a Professor of Anesthesia and Critical Care Medicine at the University of Southampton and leader of the Critical Care Research Area within the Southampton NIHR Respiratory Biomedical Research Unit, said, “Our study has identified a striking association between staffing levels, clinical experience, and patient outcomes. This raises important questions about how emergency surgery is delivered within hospitals and across the NHS as a whole.”
Furthermore, it was even noted that amongst the Trusts that fared better results in mortality rates, the patients that they cared for had a greater occurrence of coming in with pre-existing medical conditions. However, these patients admitted in the said Trusts were 27 percent more likely to suffer complications during treatment. These facilities also had higher patient-to-medical staff (e.g. surgical consultants, junior surgical doctors, and nurses) employed.
But despite these Trusts statistics of a higher recorded complication rate, these institutions were noted to have 60 percent fewer deaths in the period of 30 days compared to the Trusts that were not performing well due to staffing conditions.
Dr. Peter Holt, the senior author of St. George’s the University of London, commented that “This is the first analysis on this scale for emergency general surgical admissions examining the associations between the numbers of senior doctors, junior doctors, and nurses per hospital bed and patient survival rates.”
“Although we have not demonstrated causation, we believe the findings should form an important part of the debate over disparities in staffing levels and resource provision between NHS Trusts,” he added.
The “Weekend Effect”
It was also apparent that the chances of death to occur, according to the study, were 11 percent higher whenever the patient was admitted in the hospital on the weekend. This was related to what was termed as a “Weekend effect,” and had sparked the interest of the Ministers in England as these rates were identified in two separate papers published by the British Medical Journal.
Professor Ravi Mahajan, the editor of the British Journal of Anaesthesia, remarked that “It seems a fair assumption that the number of senior staff and availability of resources at the weekend would be less than during the week. The acute NHS Trusts now have the challenge to explore new and innovative ways of increasing access to senior medical advice and other resources during weekend hours.”
Dr. Holt also pointed out that there would be a number of factors behind the higher death frequency during the weekends, but nevertheless, staffing was definitely one of those. He also added that the government should focus on the acquisition of immediate medical care before putting non-urgent services in the higher priority line.
The situation at hand had been given attention by the government, where it was mandated that a safe margin of nurses to patient ratio should be implemented at all cost to engender advocacy towards patient safety.
However, several administrations still had cases of understaffing, producing an area of conflict between the business sectors as hospitals and other healthcare facilities would still try to maximize the doctors, nurses, and other resources that they had by increasing their workload to possibly generate more revenue.
This cost-cutting scheme of not implementing the minimum ratio had brought dangers to the nurses and patients alike, leading to staffing dissatisfaction, doctor and nurse attritions, and patient complications and mortality.