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Nursing cuts could lead to more hospital deaths, says Lancet

Author: Neil Fearn  Bullet  Dated: 28/02/2014

The distinguished medical journal analysed nurse-patient ratios in 9 European countries, examining 300 hospitals and over 420,000 patients.

Higher here than elsewhere in Europe

The Lancet found a higher ratio here than in some European countries, estimating that in England an average of 9 patients are looked after by one nurse and called for at least 1 nurse for every 8 patients.

The ratio in Norway is 5.2 to 1, in Ireland 6.9 to 1, in the Netherlands 7 to 1 and in Sweden 7.6 to 1. Spain's nursing staff proved the most overworked, recording a ratio of 12.7 to 1.

The study examined the relationships between nurses' education and workloads with patients' results. Among the influencing factors were types of surgery, patients' genders and ages, whether any illnesses were deemed chronic and each hospital's available technology.

Mortality rates vary

The total number of mortalities within 1 month of surgery was generally low, averaging 1 to 1.5% for each country and 1.4% in England. But mortality rates per-hospital were substantially varied, with some recording 7% of patient deaths within 30 days of a procedure.

"Concern" – RCN

The Chief Executive of the RCN, Peter Carter, said the nurse-patient ratio in England gives him cause for concern.

"It is worrying to see that researchers found the mean ratio of patients to nurses in England is above 8, as we know that this can compromise patient safety," Mr Carter said.

"The RCN has also expressed concern at the skills mix in UK hospitals as trusts get rid of more senior nurses to save money, meaning there is far less experience on many wards, and the full extent of this will be revealed in our upcoming Frontline First report."

Cuts pose risks to patients, say researchers

The Lancet's research leader, Prof Linda Aiken of the University of Pennsylvania, said the journal's findings underline how cuts to nursing staff can pose heightened risks to patients.

"They also suggest that an increased emphasis on bachelor's education for nurses could reduce hospital deaths," Prof Aiken said. "Our data suggests that a safe level of hospital nursing staff might help to reduce surgical mortality. It also challenges the widely held view that nurses' experience is more important than their education."

Freshly-qualified nursing staff are obliged to have university degrees since September 2013.

Compassion and education the key

While emphasising the importance of caring to nurses' training and practice, Mr Carter said compassion must be allied to better education.

"Modern medicine means that a nurse's role is far more technical," Mr Carter said. "[It] requires complex decision making which demands a degree level education as well as the practical experience which currently makes up at least half of a nursing degree."

In response last November to the Mid Staffs hospital scandal, the Health Secretary declined to establish a minimum nurse-patient ratio.

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