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Nurse staff levels and education affect patient outcomes, study finds

Sunday June 15, 2014
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Hospitals in nine European countries where nursing staff care for fewer patients and have a higher proportion of bachelor’s degree-trained nurses had significantly fewer surgical patients die while hospitalized, a recent study found. The findings underscore the potential risks to patients when nurse staffing is cut and suggest an increased emphasis on bachelor’s education for nurses could reduce hospital deaths, according to a National Institutes of Health press release.

The study, which was supported by the European Union’s Seventh Framework Programme and the National Institute of Nursing Research, part of the NIH, provided a detailed analysis of patient outcomes associated with nurse staffing and education in Europe.

Known as Registered Nurses Forecasting, the study estimated an increase of one patient in hospital nurses’ workloads increases the likelihood of inpatient hospital death by 7%. A better educated nurse workforce also was associated with fewer deaths. For every 10% increase in nurses with bachelor’s degrees, there was an associated drop in the likelihood of death by 7%. Results of the study were published earlier this year in The Lancet, a weekly peer-reviewed medical journal.

“Building the scientific foundation for clinical practice has long been a crucial goal of nursing research and the work supported by NINR,” NINR Director Patricia A. Grady, RN, PHD, FAAN, said in the release. “This study emphasizes the role that nurses play in ensuring successful patient outcomes and underscores the need for a well-educated nursing workforce.”

For the study, a consortium of scientists reviewed hospital discharge data of nearly 500,000 patients from nine European countries who underwent common surgeries. They also surveyed more than 26,500 nurses practicing in study hospitals to measure nurse staffing and education levels. The team analyzed the data and surveys to assess the effects of nursing factors on the likelihood of patients dying within 30 days of hospital admission.

Based on their analysis, the researchers estimated patients in hospitals where 60% of nurses had bachelor’s degrees and cared for an average of six patients had a nearly one-third lower risk of dying in the hospital after surgery than patients in hospitals where only one-third of nurses had bachelor’s level education and cared for an average of eight patients each.

In the U.S., analysis of patient outcomes associated with nurse staffing practices has resulted in proposed or actual legislation in nearly 25 states. The study also lends support to the recommendation of the Institute of Medicine that 80% of nurses in the U.S. have a bachelor’s degree by 2020, according to the release.


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