Nurse staffing and patient outcomes

Researchers

Sarahjane Jones, Centre for Social Care, Health and Related Research

Background

This collaborative study investigated the links between variable patient wellbeing and how registered nurses deliver care to their patients. The project was led by London South Bank University and funded by NHS England, and included Birmingham City University, University Hospital Coventry & Warwickshire NHS Trust and Wolfram Research as collaborators.  

Research approach and outcomes

The study entitled, ‘Mining routinely collected acute data to reveal non-linear relationships between nurse staffing levels and outcomes’ shows that the number and type of nurses, such as registered nurses or healthcare support workers, has a direct effect on safety outcomes such as falls and the management of symptoms like nausea and vomiting.

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

Large volumes of routinely collected hospital data were used and the analysis and different possible scenarios were considered. One example scenario 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 per cent.

Falls are also costly in terms of their impact on patient wellbeing, resulting in distress, pain, injury, loss of confidence, loss of independence, a crippling impact on personal finances and mortality.  For example, in 2007 falls in hospital were estimated to cost the NHS more than £15million a year. 

The research was conducted at one hospital in England, but the techniques could be applied in other centres, provided good quality data is available.

Research outputs

The research has been published in BMJ Open.