Increasing the ratio of registered nurses to patients significantly improves the perceived quality of care on hospital wards, according to early findings from a major study.
Researchers at King’s College London and Southampton University last week presented preliminary findings from a survey of 400 wards across more than 46 hospitals in England, showing the impact of reducing numbers of registered nurses.
The findings revealed the number of patients per nurse on day shifts varied from five to 10. Skill mix was also varied, with registered nurses comprising between 43% and 68% of all nursing staff across different wards.
Overall, 31% of the 3,000 nurses taking part rated care in their ward as excellent, while half said it was good and a fifth said it was poor or fair.
But those who said it was poor or fair worked in wards that had on average nine patients per nurse. This dropped to seven patients per nurse on average for those who described the care as excellent.
Southampton University professor of health services research Peter Griffiths told Nursing Times: “This shows there are consequences for reducing the registered nurse workforce. It strongly suggests that the push to substitute nursing aides for registered nurses as a cost saving measure is unlikely to achieve adequate quality of care.”
Trusts planning to swap nurses with healthcare assistants or assistant practitioners needed to monitor the impact on care, he warned.
Professor Griffiths added: “Mid Staffordshire Foundation Trust provides a fantastic narrative of a trust that was experimenting with its workforce but didn’t see the need to monitor the consequences.”
He admitted nurses’ perceptions of care quality were not necessarily accurate, but said research had shown they were often closely linked with more objective measures.
The research also found that three quarters of nurses surveyed said that on their last shift they lacked time to comfort or talk with patients, while 40% said patient surveillance had suffered. A third said patients’ oral hygiene had been neglected.
Asked about “negative events” that happened on a monthly basis in their wards, 55 per cent said pneumonia, half said urinary tract infections and 44 per cent said patients had injured themselves after falling.
The final report on Human Resources Management for Nursing in Europe, a study on the impact of nurse deployment on patient safety is expected to be published by the end of the year.