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Mandatory staffing ratios aid recruitment and retention

  • 30 Comments

Setting minimum staff to patient ratios could create a more stable nursing workforce that is less dependent on agency cover, while improving safety, according to the latest academic review.

The government has so far rejected calls to introduce minimum registered nurse to patient ratios, despite repeated calls from nursing unions.

The National Nursing Research Unit at King’s College London looked at international evidence from places where ratios have been introduced. 

California set a ratio of 1:5 on medical and surgical wards in 1999. The review found no evidence the move had increased costs and said nurses typically cared for one less patient than in other US states.

Mandatory ratios were introduced in the Australian state of Victoria in 2001 and set at 1:4, plus one manager. Studies had shown the ratios had led to better recruitment and retention of nurses, more workplace stability and reduced stress, the review said. 

The evidence suggested mandated ratios could “improve nurse staffing and lead to better recruitment, generate a more stable workforce, and more manageable workloads for staff”, the review stated.

“The impact on patient outcomes is less clear but there is evidence that the resultant lower caseloads are related to lower levels of patient mortality,” it added.

Ratios are “arguably simple and easy to use”, the review said, but it noted investment would be required to set up and monitor them. “Careful consideration” would need to be paid to variations in patient needs, especially between specialities, it added.

Unison called on nurses to record the number of patients per staff member on their wards earlier this month as part of a national survey.

  • 30 Comments

Readers' comments (30)

  • Little One

    No s**t Sherlock, a better Nurse: Patient ratio leads to lower patient mortality? There's a surprise....




    My 2 year old niece could tell you that the fewer people you look after the better you can look after them.

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  • why is repeated over and over and nothing done about it. It seems pointless to repeat what everybody is already aware of.

    Nurses have been saying this for a long time.

    Why does it have to be repeated. Maybe it is because those who consider themselves more important than nurses have found out and have to say it as well!

    Who is actually going to do something about it?

    Why is it the government who decides what patients need and how it should be delivered?

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  • Nurses have been saying this for years but no-one took any notice. Now someone else is happy to take the credit for publishing evidence that we all knew was there.

    Let's hope that something is done about the appalling staffing levels, otherwise this has all just been a complete waste of time.

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  • why do they always have to waste money and time to prove what is obvious!!!!!!!!!!!!

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  • Anonymous | 21-Mar-2012 9:10 am
    and
    Anonymous | 21-Mar-2012 9:29 am

    There is no point in hoping "... that something is done about the appalling staffing levels,....."

    Unless and until nurses themselves actually DO something about this, then nothing will ever be done about staffing ratios.

    This silliness of asking nicely for more nurses and backing it up with another report which will be ignored, is totally pointless. Nurses, the unions and prfessional bodies need to take robust action about this. If we don't then our patients and ourselves will suffer. Ask yourselves today....Have I raised this issue with management at work (and backed it up with the evidence, incident reports, etc), and having been ignored, do I keep at them? Have I spoken to my union/professional organisation, asked for support and guidance, and do I know what my union is doing about staff/patient ratios? Have I lobbied my MP? Would I be prepared to actually do something about this? Or am I just moaning because I feel that no one listens to us anyway?

    I am sorry, but I know the answer for most nurses to most of those questions, with the exception of the last one, is NO. Nurses have it in their power to take action on a variety of fronts, but choose not to. It is too easy to blame the government alone for this when we are so complicit.

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  • "Have I raised this issue with management at work (and backed it up with the evidence, incident reports, etc), and having been ignored, do I keep at them?"

    does anybody actually approach management, up the line of hierarchy, asking specific questions and insisting until concrete answers are given to each question and also insisting on further and regular feedback on progress. It seems it is too passive just presenting a report which can be put in a pile and then just keeping at them to see whether they are taking any action. To elicit the definite answers one expects many people need to be asked very specific and clear questions and then pinned down until they give a specific answer.

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  • Anonymous | 21-Mar-2012 1:38 pm
    from
    Anonymous | 21-Mar-2012 12:45 pm

    I think that you have broadly taken my point. ie. Inaction is not an option if you want to effect change.

    However, to clarify my point about taking on management, it isn't about "....just presenting a report which can be put in a pile and then just keeping at them to see whether they are taking any action.." That wasn't what I said. To make a effective argument, there must be valid evidence to back it up. Even if they choose to ignore it, the evidence exists, so that when you go to the next stage/person/etc (which is 'keeping at them'), you have a firmer base for your case. If you haven't taken the most basic steps to address issues in your workplace, then how can you ever be surprised that you are not listened to?

    As for, "....many people need to be asked very specific and clear questions and then pinned down until they give a specific answer." Hmm. Not so much. Why waste TOO much time faffing around with that? Which brings me back to my point. If enough nurses took enough action, the landscape would change completely.

    Personally, I don't think that anything less than industrial action (and I didn't mention the 'S' word) will change anything in the NHS. But I don't think for one minute that nurses as a profession have the guts to fight our corner. And I have the evidence to prove it.



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  • Anonymous | 21-Mar-2012 2:11 pm

    "That wasn't what I said."

    It wasn't what you said, it is what I said! I was just taking up your comment to make further ones of my own.

    In fact my first sentence I have just noticed I omitted the question mark if that makes it any clearer as I just wondered if this is what happens some of the time and documents just go in a pile.

    Communication sometimes, or maybe I could be more blunt and say often, fails unless one makes it absolutely clear exactly what they want or want to know even if it means spelling it out. I would think this could save time in the long run.

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  • Anonymous | 21-Mar-2012 12:45 pm

    Sad to say. I have to agree wholeheartedly. This profession has done nothing but stand idly by, watching the destruction of the NHS from the sidelines. Nursing is drowning in its own irrelevance.

    I can no longer stand the hand-wringing of my passive colleagues. It is sickening.

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  • Anonymous | 21-Mar-2012 3:11 pm

    How can mandatory staffing ratios be introduced when official figures have just been published in DT on several thousands of nurses who have left the NHS? It doesn't seem to add up unless there are still sufficient numbers left for mandatory staffing levels. According to reports of shortages in the media this does not seem to be the case. On the other hand does this mean recruiting new nurses again to make up the numbers but this makes little sense as nursing staff have been cut to make financial savings?

    "This profession has done nothing but stand idly by, watching the destruction of the NHS from the sidelines."

    Please may I also ask how this situation has really evolved and been allowed to develop to the extent of the destruction of the NHS. Is it really just apathy of the nurses? Could more have been done to prevent this situation? or is has this only been perceived in hindsight?

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