Updated: May 12, 2021 7:56:54 am
The years 2020–21 have been designated by WHO as the International Year of the Nurse and Midwife to honour the 200th anniversary of Florence Nightingale’s birth, Nightingale’s innovative work with statistics showed the importance of hospital hygiene in preventing deaths; her research showed trained nurses were associated with reduced hospital deaths. May 12, Florence Nightingale’s birth anniversary, is International Nurses Day.
New research suggests that patient harm can be further reduced by investments in nurse staffing. A study across 55 hospitals in Queensland, Australia suggests that a recent state policy to introduce a minimum ratio of one nurse to four patients for day shifts has successfully improved patient care, with a 7% drop in the chance of death and readmission, and a 3% reduction in length of stay for every one less patient a nurse has on their workload.
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The study of more than 400,000 patients and 17,000 nurses in 27 hospitals that implemented the policy and 28 comparison hospitals has been published in The Lancet. In 2016, 27 public hospitals in Queensland were required to instate a minimum of one dedicated nurse for every four patients during day shifts and one for every seven patients for night shifts on medical-surgical wards.
The research team collected data from those 27 Queensland hospitals that instated ratios and from 28 other hospitals in the state that did not, at baseline in 2016 and at follow-up in 2018 (two years after the policy was implemented). Only nurses in direct contact with adult patients in medical-surgical wards were included.
Researchers used patient data to assess demographics, diagnoses, and discharge details for patients, as well as length of hospital stay. These data were then linked to death records for 30 days following discharge, and to readmissions within seven days of discharge.
The chances of being readmitted increased by 6% in the comparison hospitals over time, but stayed the same in hospitals that implemented the policy. Between 2016 and 2018, the length of stay fell by 5% in the hospitals that did not implement the policy, and by 9% in hospitals that did.
When nurse workloads improved by one less patient per nurse, the chance of death and readmissions fell by 7%, and the length of hospital stay dropped by 3%.
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