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Dr Foster reveals link between Nursing levels and patient care 7 April 2009

Dr Foster’s latest research as reported in the Nursing Times (31 March 2009) reveals the extent to which nursing staff levels can impact on patient mortality rates in England’s hospitals. The report shows there are lower mortality rates and shorter hospital stays in acute trusts that have more nurses per bed.

Staffing levels in 147 acute trusts with A&E departments were analysed between 1 April 2007 and 31 March 2008 and compared with data on national hospital activity for day care and inpatients in England. Key findings showed:

  • Of 49 trusts with the lowest nurse per bed ratios, nearly half are rated as having a high death rate (known as hospital standardised mortality ratio – HSMR)
  • Of 49 trusts with a high nurse per bed ratio, again, nearly half had a low patient death rate
  • In trusts with 1.4 or fewer nurses per bed, 25% of patients are likely to be very long-stayers (when length of stay exceeds 75% of patients in England with a similar diagnosis and admission type in a certain year)

Dr Simon Jones, chief statistician at Dr Foster Intelligence, leading the research said:
"This data shows that nursing levels are an important factor in ensuring a low death rate in hospitals, but it’s important to recognise there are also other reasons which could influence an outcome. For example, just having more nurses is not enough, they need to work effectively; and having more local GPs could in fact counter a low nurse level and not adversely affect patient death rates.

"What is clear is that the warning bells should sound when there is a combination of low nursing levels coupled with a low number of GPs locally – this is where we see the highest impact in terms of patient deaths."

The research was picked up widely in the media, especially on a local level:

Swindon Advertiser
GWH takes action to reduce death rates
Blackpool Gazette
Death rates at Vic among UK's worst
Birmingham Post
Midland hospital death rates linked to nurse shortages
Wolverhampton expressandstar.com
Nurse-bed ratio linked to deaths
Derbyshire Times
Hospital defends nurse levels
Coventry Telegraph
Warwick Hospital death rates too high, according to research

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