News

Nurses must take evidence on safe staffing to the highest levels

Pioneering researcher says it is time for nurses and governments to act.
Linda Aiken

A pioneering nurse researcher who has led global studies on safe staffing has said it is time for nurses and governments to act on the body of evidence.

The University of Pennsylvania's Center for Health Outcomes and Policy Research director Linda Aiken said evidence from 30 countries worldwide all points to a link between staffing levels and patient mortality.

Her call comes as the RCN is demanding nurse safe staffing levels to be enshrined in law across the UK, warning that NHS patients face falling care standards without such legislation.

Global issue

Speaking at the International Council of Nurses (ICN) 2017 congress in Barcelona yesterday, Dr Aiken said evidence on nurse staffing was the same in different countries.

Overall we have the same findings showing the impact of nurse

A pioneering nurse researcher who has led global studies on safe staffing has said it is time for nurses and governments to act on the body of evidence.


Linda Aiken wants evidence to be turned into practice. Picture: Martin Ellard

The University of Pennsylvania's Center for Health Outcomes and Policy Research director Linda Aiken said evidence from 30 countries worldwide all points to a link between staffing levels and patient mortality.

Her call comes as the RCN is demanding nurse safe staffing levels to be enshrined in law across the UK, warning that NHS patients face falling care standards without such legislation.

Global issue

Speaking at the International Council of Nurses (ICN) 2017 congress in Barcelona yesterday, Dr Aiken said evidence on nurse staffing was the same in different countries. 

‘Overall we have the same findings showing the impact of nurse staffing on [patient] outcomes,' said Dr Aiken. 

‘Not just in hospitals, but in every setting – in primary care, home care, older care – in every setting all over the world.’

She received a standing ovation from the congress audience after her address.

Patient mortality

Dr Aiken emphasised that the data was clear on the correlation between nurse staffing numbers and patient mortality.

‘Every one [surgical] patient increase in a nurse's workload is associated with a 7% increase in mortality whether in Europe, the US or Korea.’

Dr Aiken, who is also a Nursing Standard editorial adviser, said evidence showed each 10% decrease in the proportion of nurses was associated with a 12% increased risk of death.

She also warned against the use of nursing assistants in place of nurses, explaining that one nursing assistant per 25 patients instead of a nurse increased the odds of a patient dying by 21%.

‘Nurses have to become more knowledgeable about the evidence and take this evidence to their policy makers,' she said.

‘We have plenty of evidence to urge governments to invest in nursing – this research has been published in some of the best journals in the world, the Lancet, the BMJ, the New England Journal of Medicine.’

Value for money

Dr Aiken, who was awarded the ICN Christiane Reimann prize on Saturday for outstanding nursing achievement, said governments were always looking for value for money.

'They think labour costs a lot of money and doesn't really improve the bottom line of the hospital,' she said, arguing that this thinking was unscientific.

She said evidence clearly showed well-staffed hospitals had a wealth of cost savings to offer managers, including:

  • Fewer intensive care unit days.
  • Shorter length of stay.
  • Fewer readmissions.
  • Fewer hospital-acquired infections.

ICN chief executive Frances Hughes agreed that 30 countries were saying the same thing about staffing environments and skills, and it was time for the evidence to be translated into practice.

'We have got to have more sophisticated communication skills and advocacy from nursing leaders – we have to get politicians engaged with this,' Dr Hughes said.

'Once they get it, it's a no-brainer and you don't have to keep fighting.

UK-wide legislation

Earlier this month, RCN general secretary Janet Davies called for UK-wide safe staffing legislation.

Hospitals in Wales will be legally obliged to implement safe nurse staffing levels in hospitals from April 2018.

Chief nursing officer for Wales Jean White said she hoped to extend the act to include one or more of the following specialties: mental health, children's inpatient services, health visiting, community district care, or nursing homes.

In April, Scotland moved a step closer to becoming the second UK country to introduce safe nurse staffing legislation for the NHS: its government launched a consultation to enshrine in law the use of nursing and midwifery workload and workforce planning tools.


In other news

Sign up to continue reading for FREE

OR

Subscribe for unlimited access

Enjoy 1 month's access for £1 and get:

  • Full access to nursing standard.com and the Nursing Standard app
  • Monthly digital edition
  • RCNi Portfolio and interactive CPD quizzes
  • RCNi Learning with 200+ evidence-based modules
  • 10 articles a month from any other RCNi journal

This article is not available as part of an institutional subscription. Why is this?

Jobs