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Low nurse ratio dubbed a risk to patients

The lives of patients are being put at risk by a global trend to make nurses care for too many patients in hospitals, according to a visiting American expert.

Linda Aiken from the University of Pennsylvania, a keynote speaker at the International Congress on Innovations in Nursing in Perth, has been studying the links between hospital performance, nursing levels and patient outcomes in 30 countries, including Australia.

She said there was a growing push to not only reduce the number of registered nurses available to care for patients, but also to substitute them with less skilled staff, and it was leading to deaths.

“We have lots of evidence that shows that if hospitals have enough nurses, the outcomes of patients are better, including the prevention of unnecessary deaths, readmission and hospital-acquired infections,” Dr Aiken said.

“And hospitals also save money by having the correct number of nurses, because it’s so expensive to take care of people with these adverse outcomes.

“Our recommendation is that governments take more of a look at the variation between hospitals in the average number of patients that nurses are taking care of.

“They can vary as much as 100 per cent from one hospital to another, and there are very big consequences for patients.”

The Australian Nursing Federation in WA has been campaigning for legislated nurse-to-patient ratios, with rules such as having no more than four patients per nurse on a general ward on day shifts. Dr Aiken said she supported standardised nurse staffing and rejected arguments by hospital administrators that they needed some flexibility.

“Patients are dying because of that flexibility, and there’s plenty of evidence that it’s impossible for nurses to safely care for patients if they have too many patients that are acutely ill,” she said.

“We know that nurses are the surveillance system for the early detection of problems … they are the ones that see them early and call in other team members to help save a patient’s life.

“But that surveillance is compromised if there are not enough registered nurses at the bedside, and other staff with less formal education don’t detect these things early enough.”

Dr Aiken said it had been almost 20 years since studies found that medical errors were a leading cause of death in hospitals in developed countries such as Australia and the US.

But progress in improving patient safety had been slower than expected and nurse staffing was a factor.

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