Pressure ulcers: link between post-surgical risk and nurse staffing
Posted 25 September 2024 - 12:45
Understaffed surgical wards have higher rates of pressure ulcers, deep vein thrombosis, post-surgical infections and higher mortality rates, research finds
Nursing staff shortages lead to higher rates of pressure ulcers, deep vein thrombosis (DVT) and post-surgical infections, a study has found.
New research by the University of Southampton also found that lower levels of nurse staffing led to longer hospital stays and higher risk of death for surgical patients.
Understaffing linked to poor outcomes for surgical patients
The study, which used surgical staffing and patient data from 200,000 hospital admissions at four NHS trusts from April 2015 to February 2020, also found there were worse health outcomes for surgical patients when nursing levels were lower.
In situations where nursing staff levels were below average for the ward, this understaffing increased the relative risk of mortality by 9.2% with each day of low numbers of registered nurses, and by 10.3% with each day of low levels of nursing assistants.
The study also indicated that shortages of registered nurses was associated with a 6.4% increase in pressure ulcers, a 5.7% increase in pneumonia and a 4.8% increase in deep vein thrombosis.
In addition understaffing increased the relative risk of readmission to hospital by 2.3% for registered nurse shortages and 1.4% for a shortage of nursing assistants.
Workload is ‘major driver of risk’ for post-surgical complications
‘The safety of patients undergoing surgery is paramount and there is rightly a considerable emphasis on appropriate systems, policies and procedures.
‘Our research is a timely reminder that workload is also a major driver of risk, and risks to surgical patients persist beyond the immediate operative period,’ said Paul Meredith, senior research fellow in the School of Health Sciences at the University of Southampton.
Often safety interventions to address post-surgery complications have focused on implementing checklists, staff training and improving teamwork.
But following analysis of the data, researchers concluded that staff shortages alone may be an important reason for infections and other adverse outcomes after operations.
Patient safety will be compromised if understaffing is not addressed, warns lead researcher
The authors of the study, published in the British Journal of Surgery, said they hoped the findings will help inform policymakers about the risks of understaffing and how to address this.
Dr Meredith added: ‘Many safety interventions have focused on implementing checklists, staff training and improving teamwork. However, leaving the onus on front-line staff to prevent harms, without addressing shortfalls in nurse staffing levels, is a persistent barrier to patient safety.
‘Adequate nurse staffing on wards is vital to ensure the safety of patients undergoing and recovering from surgery.’
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