More nursing staff in hospitals reduces the number of deaths, the length of stay and the number of new hospital admissions – and thus even cuts costs.
More nurses in clinics reduce the number of deaths, length of stay and the number of re-hospitalizations. This is shown by a study that appeared in the specialist journal Lancet. For this purpose, data from clinics in Queensland, Australia were evaluated.
A new guideline was introduced in 27 clinics, according to which the minimum ratio between nurse and patient should be 1: 4 in the day shift and 1: 7 in the night shift. The study period was two years. Result: Better staffing improved patient care. The probability of death and re-admission as well as the length of stay decreased.
Half of the hospitals had increased their staff
The survey included more than 400,000 patients and 17,000 nurses from the 27 hospitals that had implemented the policy and 28 hospitals that did not. Here the ratio of nurses to patients remained constant at 1: 6. Another result: the savings from shorter hospital stays and fewer re-admissions were twice as high as the costs of hiring more staff.
“Our results close a critical data gap,” said lead author Prof. Matthew McHugh of the University of Pennsylvania School of Nursing, in a Lancet press release. A lack of data on the long-term effects and costs would have prevented the widespread introduction of minimum staff numbers.
Length of stay, repeated admission, death rate recorded
Only nurses who looked after adult patients in medical-surgical wards were included. Demographics, diagnoses, discharge details, length of hospital stay, deaths up to 30 days after discharge and re-admissions within seven days of discharge were recorded for the patients.
The researchers found that between 2016 and 2018, the probability of death increased by 7 percent in hospitals that did not implement the policy and decreased by 11 percent in hospitals that did. The likelihood of re-admission increased by 6 percent in the comparator hospitals and remained the same in the hospitals that implemented the policy.
More nurses in clinics reduce deaths
Between 2016 and 2018, length of stay decreased by 5 percent in hospitals that did not implement the directive and by 9 percent in hospitals that did implement it. On average, if the nursing workload improved by one less patient per nurse, the likelihood of death and re-admission decreased by 7 percent and the length of hospital stay decreased by 3 percent.
More nursing staff in clinics therefore reduces the number of deaths. Without the implementation of the guideline, the researchers estimate that there would have been 145 more deaths, 255 more re-admissions and 29,222 additional hospital days in the 27 hospitals.
More nursing staff, more savings
The researchers also calculated the cost of funding the 167 additional staff required to implement the policy: it was $ 33 million compared to the $ 69.6 million saved in improved patient care.
“A clear return on investment. Often decision makers are concerned about whether they can afford to implement such a policy. We would encourage governments to look at these numbers and see if they can afford not to “says Prof. Patsy Yates of the Queensland University of Technology Nursing School.
Minimum staffing levels in Germany
In Germany there are minimum staffing levels in the clinics, the amount depends on the ward.
- Intensive care medicine and pediatric intensive care medicine: day shift 2 patients per nurse; Night shift 3 patients per nurse.
- Geriatrics day shift 10 patients per nurse; Night shift 20 patients per nurse.
- General surgery and trauma surgery: 10 patients per day shift per nurse; Night shift 20 patients per nurse.
- Internal medicine and cardiology: day shift 10 patients per nurse; Night shift 22 patients per nurse.
- Cardiac surgery: 7 patients day shift per nurse; Night shift 15 patients per nurse.
- Neurology: day shift 10 patients per nurse; Night shift 20 patients per nurse.
- Neurological stroke unit: day shift 3 patients per nurse; Night shift 5 patients per nurse.
- Neurological early rehabilitation: day shift 5 patients per nurse; Night shift 12 patients per nurse.
- Pediatrics: day shift 6 patients per nurse; Night shift 10 patients per nurse.
Photo: Adobe Stock / Jacob Lund
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