Nurse Shortage: A Significant Risk to Surgical Patient Safety

Discover how nursing shortages are linked to longer hospital stays, higher mortality, and worse patient outcomes in surgical wards.

Nurse shortages lead to worse patient outcomes, including increased mortality and longer hospital stays. An article published in the British Journal of Surgery highlights that staffing shortages affect patient care ().

Over 300 million procedures are performed by doctors globally each year. A growing number of adult surgical patients are experiencing preventable complications, prolonged hospital stays, and readmissions, which has raised concerns about the quality of care provided to these patients. Approximately 55% of infections at the surgical site are avoidable.

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Role of Nurses in Patient Safety

To date, the majority of safety measures aimed at addressing issues have centered around the implementation of checklists, staff training, and enhancing teamwork.

Still, a major contributing factor to infections and other postoperative complications could be a lack of staff. Keeping surgical patients safe and healthy is an integral responsibility of nurses.

Increased risks of various unfavorable occurrences are linked to understaffing of both registered nurses and nursing assistants.

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One recent review of 44 studies found that higher nurse staffing levels were associated with lower 30-day mortality among surgical patients. However, most studies have focused on staffing at the hospital level, rather than in actual surgical wards.

In this new paper researchers from the University of Southampton, using surgical patient and staffing data from 213,910 hospital admissions from four medical institutions in the English National Health Service, explored outcomes between April 2015 and February 2020.

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In situations where staffing levels were below the mean for the ward, researchers found that such understaffing increases the relative risk of readmission by 2.3% for nursing shortages (and by 1.4% for nursing assistant shortages).

Importance of Adequate Staffing in Surgical Wards

The study indicated that nursing shortages were associated with 4.8% increases in deep vein thrombosis, 5.7% increases in pneumonia, and 6.4% increases in pressure ulcers.

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The relative risk of mortality increased by 9.2% with each day of low registered nurse staffing and by 10.3% for each day of low nursing assistant staffing.

“The safety of patients undergoing surgery is paramount and there is rightly a considerable emphasis on appropriate systems, policies, and procedures,” said the paper’s lead author, Paul Meredith.

“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.”

Reference:

Nurse understaffing associated with adverse outcomes for surgical admissions - (https:academic.oup.com/bjs/article/111/9/znae215/7763108)

Source-Eurekalert