A new study by researchers from the University of Southampton found that nurse shortages are associated with worse health outcomes, longer hospital stays and increased patient mortality for surgical admissions.
Doctors perform over 300 million operations worldwide each year. There is growing concern over the rising cost of avoidable complications, extended hospital stays and readmissions. Up to 55% of surgical site infections are preventable.
Until now, efforts to improve surgical patient outcomes have focused on implementing checklists, staff training and improving teamwork. However, Southampton research has highlighted the importance of also addressing staff shortages.
Increased mortality risk
The Southampton team used data from over 200,000 hospital admissions at 4 NHS Trusts to explore surgical patient outcomes between April 2015 and February 2020.
The researchers found that for each day nursing staff levels were below average for a ward, the relative risk of mortality increased by 9.2%. For wards with low levels of nursing assistants, the daily increase of relative risk of mortality was 10.3%.
The study, published in the British Journal of Surgery, showed that shortages of registered nurses were associated with the following increases in cases:
- 4.8% in deep vein thrombosis
- 5.7% in pneumonia
- 6.4% in pressure ulcers
It also showed understaffing increased the relative risk of readmission to hospital by 2.3% for nurse shortages and 1.4% for nursing assistants.
The safety of patients undergoing surgery is paramount and there is rightly a considerable emphasis on appropriate systems, policies, and procedures. Our 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.
Dr Paul Meredith, Senior Research Fellow in the School of Health Sciences .
The researchers concluded that staff shortages alone may be an important reason for infections and other adverse outcomes after operations. They hope this new study will help inform policymakers about the risks of understaffing and how this can best be addressed.
