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Patients notice when there are not enough nurses, will policymakers too?

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“When there aren’t enough professional nurses, things get missed, patients notice, and this affects their confidence in the quality of the hospital and the care they receive.”

This was the conclusion of one of the leading UK academics involved in a major piece of research, published late on Thursday night, into how patient satisfaction is affected by nurse staffing levels.

Professor Peter Griffiths and his team went on to say that increasing registered nurse staffing was likely to improve patients’ perceptions of the care they receive.

If this sounds like déjà vu to you, you would not be wrong. The same team have used the same set of data – from the seminal RN4CAST nursing workforce study – to draw similar conclusions in the past.

“This analysis dispels any view that “uncaring” nurses are the root of unfavourable patient ratings in England”

Essentially, and probably not surprisingly, all the evidence points to more registered nurses resulting in a better deal for patients.

While they previously looked at the relationship between staffing and patient outcomes (such as missed care and mortality rates), the new study took a different approach – the views of patients themselves.

The researchers analysed thousands of patient survey results from general and surgical wards at NHS hospitals in England, alongside the RN4CAST data on missed care reported by thousands of nurses at those trusts.

Just from the survey itself, they found that 57% of patients, who believed there were “always” enough nurses on duty, said they had excellent care in the group. Compare that with just 27% who reported excellent care if there were “sometimes” enough nurses, and 14% who had “rarely” or “never” enough nurses.

“Could this research be the cherry on the top of the already compelling evidence about higher registered nurse staffing levels improving patient mortality?”

When both data sets were merged, they found patients were less likely to say their care was excellent at organisations where there was more missed care, which itself was linked to higher numbers of patients per nurse.

Importantly, the team makes specific reference to the fact that this analysis dispels any view that “uncaring” nurses are the root of unfavourable patient ratings in England – despite this belief having been the basis for recent NHS workforce initiatives.

While patient survival and timely care is clearly paramount, an overall quality of care is what nurses want to be able to provide.

This study explains the importance of this to patients as well – crucially how this is strongly linked to staffing levels, not the attitudes of staff. And not just any staffing levels either, but specifically registered nurse staffing levels.

“More nurses are the key to both safer care and also perceptions of the quality of care”

“Having more staff on the wards, who have limited qualifications is not enough – the NHS needs to focus on achieving safe registered nurse staffing levels as a means to achieve better outcomes, including improving patients’ satisfaction with their care,” said Professor Griffiths.

Could this research be the cherry on the top of the already compelling evidence about higher registered nurse staffing levels improving patient mortality?

There is nowhere for policymakers to hide on this issue – more registered nurses are not only what the profession wants, but patients do too.

More nurses are the key to both safer care and also perceptions of the quality of care. It’s not rocket science but for so long policymakers have made excuses on the issue –now we have the evidence.

As Professor Griffiths has pointed out “when there aren’t enough professional nurses, things get missed, patients notice”. Will policymakers notice too?

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