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Extra hour of registered nursing care per patient cuts mortality

A boost in care hours given by nurses reduced bed days, study found

A boost in care hours given by nurses reduced bed days, study found


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Having adequate nurses to give one extra hour of care per patient per day may significantly reduce mortality, according to an academic.

University of Southampton chair of health services research Peter Griffiths said analysis of one NHS acute provider suggested an additional daily hour of care per patient resulted in 219 fewer deaths each year.

The analysis is based on data collected over three years from the trust in England.

Staffing costs offset by reduced bed days

Professor Griffiths told the Patient Safety Congress 2018 in Manchester: ‘An additional registered nurse hour, per patient, per day would add about £10 million to that trust’s budget.'

But in addition to the reducing deaths, Professor Griffiths said paying for sufficient nurses to give that extra hour of care to every patient would save 10,636 bed days per year.

‘There’s no substitute for nurses’

In contrast, Professor Griffths said if the trust he analysed executed its existing plan merely to narrow the gap between numbers of healthcare assistants and nurses, it would cost an extra £1.3 million, but result in only 50 fewer deaths and 4,464 bed days saved.

‘We keep trying to convince ourselves other mixes work when the evidence-based solution is staring us in the face’

Speaking to Nursing Standard after the event, organised by HSJ, Professor Griffths said the research demonstrated there was no substitute – such as nursing associates – for having more registered nurses.

'We keep trying to convince ourselves other mixes work when the evidence-based solution is staring us in the face.

'We also think it might be unaffordable but the cost analysis proves otherwise because it delivers more efficient care.'

'While we know there are difficulties in achieving a full registered nurse staffing level, this reminds us that it is a desirable goal,' he said. 

'We keep trying to convince ourselves other mixes work when the evidence-based solution is staring us in the face. We think it might be unaffordable but the cost analysis proves otherwise because it delivers more efficient care.'

No ‘magic number’ for safe staffing

Speaking at the congress session on applying evidence and policy to practice, Professor Griffiths said there was too often a focus on finding a ‘magic number’ for safe staffing.

‘If you put more nurses in, you reduce the risk of death: end of story’

‘For every additional hour of registered nurse care the patient experienced over their hospital stay there is a decrease in the risk of death by 3%,’ he said.

‘Importantly, the relationship appears to be a linear one, there is no magic number. If you put more nurses in, you reduce the risk of death: end of story.’

Fellow conference speaker, Hull and East Yorkshire Trust executive chief nurse Mike Wright, warned against blindly ‘ticking boxes’ in relation to staffing levels, pointing out that three experienced nurses were likely to be more effective than four, if one was newly qualified.

He said healthcare staffing discussions needed to encompass the multidisciplinary team.

‘There has been or what seems like a relentless focus on nursing and midwifery staffing and I would welcome a broader look at the greater workforce,’ he said.

‘We need to start thinking about what’s the perfect team to deliver care, not just nurses and midwives.’


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