Inadequate staffing of both registered nurses and nurse assistants is associated with a higher risk of adverse events.
While many healthcare workers suffer emotionally, psychologically and physically from long working hours due to doctor-patient ratios, new research shows that nurse shortages lead to longer hospital stays and poorer patient outcomes, including higher mortality.
Researchers from the University of Southampton demonstrated this by analysing the outcomes of 213,910 hospital admissions at four NHS medical facilities between April 2015 and February 2020, using surgical patient and staffing data.
The results, published in the British Journal of Surgery, showed that the relative risk of death increased by 9.2 per cent for every day of low registered nurse staffing and by 10.3 per cent for every day of low nursing assistant staffing.
Doctors perform more than 300 million operations worldwide each year, according to the World Health Organization (WHO).
Concerns have been raised about the quality of care for adult patients undergoing surgery and the increasing costs of preventable complications, longer hospital stays and readmissions. Approximately 53 per cent of surgical site infections are preventable, notes WHO.
To date, safety measures to address this issue have focused on implementing checklists, training staff and improving teamwork.
However, staff shortages alone can contribute significantly to infections and other negative outcomes after surgery, according to researchers.
Nurses play a critical role in ensuring the safety and well-being of surgical patients. Inadequate staffing of both registered nurses and nurse assistants is associated with a higher risk of several adverse events.
The study shows that in cases where staffing levels were below the average for the unit, the relative risk of readmission increased by 2.3 per cent for nurse shortages and 1.4 per cent for nurse assistant shortages.
The study found that nursing shortages were associated with a 4.8 per cent increase in deep vein thrombosis, a 5.7 per cent increase in pneumonia and a 6.4 per cent increase in pressure ulcers.
“The safety of patients undergoing surgery is paramount and there is rightly a considerable emphasis on appropriate systems, policies and procedures.
This research is a timely reminder that workload is also a major driver of risk and that risks to surgical patients persist beyond the immediate operative period.
Adequate nurse staffing on wards is vital to ensure the safety of patients undergoing and recovering from surgery,” said Mr Paul Meredith, lead author of the study.
There is a significant global shortage of human resources for health, with low-income countries, particularly in sub-Saharan Africa and parts of Asia, bearing the greatest burden.
This shortage has not only significantly hampered the achievement of health-related development goals, but also impeded progress towards universal health coverage.
The WHO estimates a global shortage of 10 million health workers by 2030, mostly in low-and middle-income countries.
The International Council of Nurses considers the global nursing shortage to be a global health emergency and stresses that sufficient investment in a well-supported global nursing workforce is essential to the recovery and rebuilding of health systems around the world.