More Nurses and Better Nurse Education Lower Inpatient Mortality

Since this is involves surgery it is related to anesthesia so I wanted to share it with our readers.

Authors: Aiken LH et al., Lancet 2014 May 24; 383:1824

Surgical patients in hospitals with better nurse-to-patient ratios and higher percentages of nurses with bachelor degrees are less likely to die within 30 days.

In an era of increasing healthcare expenditures, trimming nursing staff is an option for containing costs. But, does doing more with less adversely affect patient outcomes? To find out, researchers surveyed more than 26,000 professional nurses at 300 hospitals in 9 European countries and obtained discharge data from these hospitals on 422,000 patients (age, greater than 50) who underwent general, orthopedic, or vascular surgery and were hospitalized for greater than 2 days around the same time as the nurse surveys.

An increase in a nurse’s workload of one patient was associated with a 7% increase in the likelihood of a surgical patient dying within 30 days of hospital admission, and every 10% increase in the percentage of nurses on staff with bachelor’s degrees was associated with a 7% decrease in this likelihood. Based on these data, patients in hospitals where 60% of nurses had bachelor’s degrees and nurses looked after an average of six patients would have almost 30% lower mortality than patients in hospitals where only 30% of the nurses had bachelor’s degrees and nurses cared for an average of eight patients.

Comment

This study adds to growing evidence that nurse staffing influences mortality in hospitalized patients (NEJM JW Hosp Med Mar 28 2011). The findings also show an association between nurses with better education and higher levels of patient safety, presumably because such nurses are better able to monitor patients and make sound clinical judgments. Although the results of this study should guide policies that would standardize safe hospital nurse staffing practices, the real determinant will be whether healthcare institutions are willing to make the financial inves