Nurse's workload 'linked to death rates'

Thursday 27 February 2014

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Nurse's workload 'linked to death rates'

Every 10 per cent increase in the proportion of nurses holding a bachelor's degree at a hospital was associated with 7 per cent lower surgical death rates, a study has shown.
Hospital patients are more likely to die after surgery if they are treated by nurses who don't have a bachelor’s degree, a study has found.


Researchers followed up more than 420,000 patients from 300 hospitals across Europe and discovered that staff training was crucial to post-op survival. Every 10 per cent increase in the proportion of nurses holding a bachelors degree at a hospital was associated with 7 per cent lower surgical death rates.
The study also found that every extra patient added to a nurse's workload also increased the risk of death by 7 per cent.

Fewer than one in three NHS nurses currently hold a degree and in some hospitals 90 per cent of nursing staff are without the qualification.

"All the hoo-ha about nurses being overeducated in our view is a gross exaggeration,” Prof Anne Marie Rafferty, from King's College London, one of the report authors. "We've only got 28 percent graduate nurses compared with say Spain or Norway which have 100 percent. “What we've found is that the higher you raise the bar and the more competitive it becomes, the talent pool expands.“We see that the move towards graduate training is a very good move and has had a positive effect on the link between nurse education and mortality rates.”

Since September 2012, every newly qualified nurse in the UK has had to possess a university degree but as training takes three years the impact will not be felt until 2015.
The study analysed information on more than 420,000 patients admitted to hospitals in Belgium, England, Finland, the Irish Republic, the Netherlands, Norway, Spain, Sweden, and Switzerland.

Researchers compared nurse workload and education and patient outcomes, taking into account a number of factors that could influence the result such as age, surgical procedure and sex.
Death rates varied significantly between individual hospitals, with some losing up to 7 per cent of surgical patients after 30 days.
The highest risk of death after surgery was found in hospitals where nurses with lower levels of education cared for the most patients, said the researchers.

A comparison was made between hospitals where each nurse cared for six patients and 60 per cent had degrees and those where nurses looked after eight patients and just 30 per cent had bachelor degrees.
The hospitals with lighter workloads and more qualified nurses were expected to have 30 per cent lower surgical death rates.

Peter Carter, chief executive of the Royal College of Nursing (RCN), said: "The RCN has expressed concern at the skills mix in UK hospitals as trusts get rid of more senior nurses to save money, meaning there is far less experience on many wards.

"Compassion and caring will always be at the heart of nursing practice and nurse training. However, the demands of modern health care mean that this must be backed up by a higher level of education so that patients, who often have complex needs, receive skilled and compassionate care. Modern medicine means that a nurse's role is far more technical and requires complex decision making which demands a degree level education as well as the practical experience which currently makes up at least half of a nursing degree."

The findings, published in The Lancet journal, included figures for 30 English hospitals showing that on average every one of their nurses looked after around nine patients.