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Registered Nurse Staffing Linked to Mortality in NHS Trusts

No beneficial association seen for health care support worker staffing with mortality


WEDNESDAY, Feb. 10, 2016 (HealthDay News) -- Registered nurse (RN) staffing is associated with reduced mortality in acute hospital National Health Service (NHS) trusts in England, according to a study published online Feb. 9 in BMJ Open.

Peter Griffiths, Ph.D., from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care in Southampton, U.K., and colleagues examined correlations between mortality and RN staffing in hospital trusts in England. They examined data from two data sets: administrative data from 137 NHS acute hospital trusts and a cross-sectional survey of 2,917 registered nurses in a subsample of 31 trusts.

The researchers observed higher mortality with more occupied beds per RN and per doctor employed by the trust (risk ratios [RRs], 1.22 [P = 0.02] and 1.10 [P < 0.01], respectively) for medical admissions. However, lower health care support worker (HCSW) staffing correlated with lower mortality (RR, 0.95; P = 0.04). After multivariable adjustment, the correlation was no longer significant for RNs. Compared to trusts with more than 10 patients per RN, trusts with an average of six patients or fewer per RN had 20 percent lower mortality (RR, 0.80; P < 0.01). After multivariable adjustment, the correlation persisted (RR, 0.89; P < 0.01).

"Ward-based RN staffing is significantly associated with reduced mortality for medical patients," the authors write. "There is little evidence for beneficial associations with HCSW staffing."

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