Wednesday, 14 January 2015

Staffing levels and patient outcomes

Roger Watson, Editor-in-Chief

Does it matter how many staff you have in a clinical area? Of course it does - we can all recall shifts with fewer than expected staff, where corners had to be cut and care delivery prioritised. But what effect does understaffing really have on the things that nurses do, or are supposed to do, and can these be measured?

In an article from Australia by Twigg et al. (2015) titled 'The impact of understaffed shifts on nurse-sensitive outcomes', the authors claim that it does.  They define nurse sensitive outcomes as 'adverse patient outcomes that can be used as indicators of the quality of nursing care' and they conducted a secondary analysis of data on a sample of over 30,000 admissions over two years. The outcomes studied were: surgical wound infection, urinary tract infection, pressure injury, pneumonia, deep vein thrombosis, upper gastrointestinal bleed, sepsis and physiological metabolic derangement.  In all cases understaffing had an adverse impact. These findings are very important and the authors are looking to expand the outcomes that could be linked to understaffing; in their own words: 'The methods developed for this study could be used to add other variables of interest at the patient level, for example patient turnover or nurse skill mix, to aid understanding of nurse staffing and the context of care and their impact on patient outcomes.'

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Twigg DE, Gelder L, Myers H (2014) The impact of understaffed shifts on nurse-sensitive outcomes Journal of Advanced Nursing doi:10.1111/jan.12616

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