Patient Mortality Increases as the Number of Nurses and Their Education Decreases

patientmortalityA new study found that the probability of a patient dying after undergoing even a simple surgery increases, as both the number and the quality of the hospital staff nurses decreases.

In a paper published in The Lancet, Linda Aiken, the lead author of the study and professor of nursing and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania in Philadelphia, stated that the difference in the patient’s outcome between those who are cared for by nurses with a bachelor’s degree and those who have not, likely to have come from the ability of the nurses to use critical thinking and utilize good decision making skills. Educational attainment may also interfere with the ability of the nursing staff to confidently discuss the patients’ cases with physicians and other hospital staff.

Aiken pointed out that current researches in nursing informatics suggest that despite developments in the medical field focusing on the patient’s safety, there was no significant progress noted in decreasing patient’s mortality. They are proposing that a possible solution to this problem might be in the nursing care.

Researchers found that for every 10% increase of quantity in the nursing staff with a bachelor’s degree, 7% decrease in patient’s mortality has been observed. On the other hand, it was observed that an additional patient added in the workload of a nursing staff increases the probability that an inpatient will die by 7%.

The study in nurse informatics used the medical records of more than 422,000 patients within 2007 and 2009. The patients included in the study where aged 50 years or over. This effort is part of the RN4CAST, a program funded by the European Commission which aims to gather information about the nurses in the workforce. 488 hospitals in 12 European countries took part in the research.

Surveys were also done which enrolled 26,000 nurses in the study. The survey was used as a means to measure the educational level of the professional nurses and to assess the usual workload of the nursing staff as per number of patients handled during a shift. Patricia Grady, director of the National Institute of Nursing Research, said that this research was a first in tackling the actual clinical outcomes to examine nursing workforce data.

The results of the study are relevant in that hospitals and policy makers are considering decreasing the costs of health care. Most of the time, they do this by cutting the quantity and quality of the nursing staff. However, through compromising the nursing workforce, it may threaten patient safety and may even increase the overall costs due to readmissions and increased morbidity and mortality.

It may seem costly to promote this advocacy now, but according to  Pat Stone, director of the Columbia University School of Nursing’s Center for Health Policy in New York, in the long run, having more educated nursing staff and ensuring that they have reasonable workloads may reduce the overall costs for the healthcare system.

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