Low nurse staffing levels put patients at greater risk of death, study warns

Patients are at greater risk of death when nurse staffing levels fall on hospital wards, according to a new study.

The research, led by academics from the University of Southampton, also indicated that patients’ vital signs were less likely to be taken when nurse staffing levels were low.

In addition, the risk of death increased when wards relied on high numbers of temporary staff.

The study assessed staffing levels on approximately 32 general medical and surgical wards, 914,000 patient days, more than 111,000 patients and 3 million sets of vital signs observations at a large NHS hospital in England between April 2012 and March 2015.

Results showed that over the first five days of hospitalisation, for each day a patient was on a ward staffed with lower than average numbers of registered nurses, the hazard of death was increased by 3%.

Significant increase in risk

Low healthcare assistant staffing was also associated with an increased risk of mortality, according to the study, called Nurse staffing, missed vital signs observations and mortality in hospital wards.

Patients whose stay included days of high patient turnover in terms of admissions per registered nurse were also associated with a significant increase in risk of death.

Vital signs observations in high risk patients were less likely to be take when registered nurse hours per patient day were low.  

When 1.5 or more hours per patient day were provided by temporary nurses the hazard of death was increased by 12%.

First study 

Peter Griffiths, who led the research, said: ‘While many people think that the link between ward staffing levels and risk of death is obvious and already established through research, previous findings have often been questioned and it has been argued that the effect on mortality is coincidental.

'This is the first study to directly demonstrate in England that changes in the risk of death directly follow periods of low nurse staffing.’

Professor Griffiths added that the research highlighted problems associated with the use of temporary nurses and the possible consequences of future shortages of nursing staff.

The early analysis of the study findings, funded by the National Institute for Health Research were presented at the RCN international nursing research conference this month.

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