Study links nurse ratios with patient deaths

The Irish Nurses and Midwives’ Organisation (INMO) has called on the Government to lift its ban on nurse recruitment after an international study found patient outcomes are worse the heavier a nurse’s workload.

The study — which examined the link between nurse staffing and education and hospital mortality in nine European countries, including Ireland — also found that a better educated nurse workforce is associated with fewer deaths.

Liam Doran, general secretary of the INMO, said the study, published in The Lancet, confirmed what the union has been saying for years, that the “savage” reduction in nursing posts since 2009 was contrary to evidence-based best practice and must be reversed.

He said: “Last year alone, there was a net reduction in nursing posts of 892. They are the Health Service Executive’s (HSE) own figures.”

Mr Doran said the Government needed to act on foot of the stark findings of the international study, which showed that every extra patient added to a nurse’s workload increases the risk of death within a month of surgery by 7%. It also found a 10% increase in the proportion of nurses holding a bachelor degree was associated with 7% lower surgical death rates.

“The challenge that arises out of this study is for policy-makers,” Mr Doran said. “The question is do they accept it? And if they do, what are they going to do about it?”

While average patient: nurse ratios in Irish hospitals compared favourably with other countries in the study — at 6.7 patients per nurse compared to 12.7 in Spain and 8.8 in the UK — Mr Doran said it should be remembered The Lancet figures referred to 2009/2010.

He said since 2009, more than 5,200 nurses had been lost to the system, reducing the nursing labour force by 13.5%.

And while he welcomed the finding that a better educated nurse workforce was associated with fewer deaths, Mr Doran said the reality was that because of the ban on recruitment, most of our graduates are emigrating since nursing became a degree level course in 2006.

The INMO is finalising the results of its own survey of nurse to patient ratios undertaken on one day in January. Mr Doran said it will look at ratios throughout a 24-hour period and the results will be published.

The authors of the RN4CAST study published in The Lancet said when budget savings are being sought “nursing is a so- called soft target because savings can be made quickly by reduction of nurse staffing, whereas savings through improved efficiency are difficult to achieve”.

The authors, which included researchers from Dublin City University, also said research into nursing “has had little policy traction in Europe compared with the USA” where almost half the 50 states have implemented or are considering hospital nurse staffing legislation.

The RG4CAST study involved more than 420,000 patients in 300 hospitals across nine European countries.

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