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Study finds ‘calculable’ link between nurse staffing levels and patient outcomes

A study has found a ‘calculable’ link between nurse staffing levels and patient outcomes.

A research study has found a compelling connection between nurse staffing levels and patient outcomes.


The number and type of healthcare staff affects safety outcomes. Picture: Tim George

Led by London South Bank University (LSBU) healthcare and workforce modelling chair Alison Leary, the study looked at 120 million patient data entries at University Hospitals Coventry and Warwickshire NHS Trust over nine years.

Published in BMJ Open journal, it shows that the number and type of staff – such as registered nurses or healthcare support workers – has a direct effect on safety outcomes including falls and the management of symptoms like nausea and vomiting.

Aspects of care

The research shows that when these aspects of care are delegated to unregistered nurses or healthcare support workers, an increase in patient falls is observed, leading to poorer patient outcomes.

Analysis of the data suggests that replacing six healthcare support workers with six registered nurses on wards with the highest incidences of falls could decrease the monthly total number of falls by 15%.

There were also fewer incidents of nausea or vomiting on wards where there were was a total establishment of 30 or more whole-time equivalent nurses.

‘Shape hospital safety’

Professor Leary said: 'We must look at the usefulness of the currently collected data and how it might be used to shape hospital safety.

'This was a very exciting project to work on as it's a different way of thinking about the contribution nurses make to patient safety. We were very surprised that so many signals emerged from the data, and it is useful that we were able to feed the new knowledge back to the trust, who then used it in many different ways to look at patient safety.

'The fact that University Hospital Coventry and Warwickshire had collected a high quality dataset over many years made this work possible.'

This study, led by LSBU and funded by NHS England, was the result of a collaboration with Birmingham City University, University Hospitals Coventry and Warwickshire NHS Trust, and Wolfram Research Europe.

Useful findings

The research was conducted at one hospital, but the authors say the techniques could be applied elsewhere, provided good quality data is available.

In conclusion, the study says: ‘The relationship between staffing and outcomes appears to exist. It appears to be non-linear, but calculable and a data-driven model appears possible. These findings could be used to build an initial mathematical model for acute staffing which could be further tested.’

Mining routinely collected acute data to reveal non-linear relationships between nurse staffing levels and outcomes


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