Higher staffing proportion of professional nurses linked to better quality

Hospitals employing a greater proportion of professionally qualified nurses relative to the number of nursing assistants have better outcomes for patients and nurses, according to a new European study published in the scientific journal BMJ Quality and Safety.

"The contention of some leaders in healthcare that fewer highly skilled professional nurses in hospitals supported by lower skilled, lower waged workers is safe and cost effective is not supported by this study," lead author Linda Aiken, PhD, RN, director of the University of Pennsylvania School of Nursing's center for health outcomes and policy research, said in a statement. "This research is consistent with a growing body of research showing that sufficient numbers of professional nurses providing direct care to hospitalized patients produces the best outcomes and avoids costly adverse care outcomes."

For the study, researchers surveyed 13,077 nurses in 243 hospitals, and 18,828 patients in 182 of the same hospitals, in hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland.

Here are three survey findings, as stated in a news release.

1. A greater proportion of professional nurses at the hospital bedside relative to the number of nurse assistants resulted in lower mortality, along with better quality and safety of care, the study found. Patients also were more likely to express satisfaction with their care.

2. In the hospitals studied, where an average of six nursing personnel (four of whom are professional nurses) care for 25 patients, replacing one professional nurse with a lower-qualified nursing assistant is associated with a 21 percent increase in mortality and a 16 percent decrease in the likelihood that patients report being satisfied with their care, according to the study.

3. Overall, the study concluded, giving professional nurses more clinical assistants does not improve patient outcomes or reduce nurse burnout, job dissatisfaction and intent to leave clinical care.


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