University of Southampton study to examine how nurse staffing levels affect care, safety of patients

A University of Southampton study will investigate how the provision of nurses in hospitals affects the care and safety of patients.

Funded by the National Institute for Health Research: Health Services and Delivery Research (HS&DR) Programme and working with Portsmouth Hospitals NHS Trust and the universities of Portsmouth and York, the research will examine the relationship between nurse staffing levels, failure to observe patients' vital signs and possible consequences - such as cardiac arrest calls, unanticipated admission to intensive care and death. Missed opportunities to observe and act upon the deterioration of a patient's condition are thought to be important factors in preventable hospital deaths.

Professor Peter Griffiths of Health Sciences at the University of Southampton will lead the research and comments: "The potential for inadequate nursing care to do patients great harm has emerged as a factor in several recent reports into failings in NHS hospitals. These have often noted that staffing levels were an important issue associated with poor care and deaths which could have been avoided.

"Our study will help give a clear picture of the relationship between staff numbers and negative patient outcomes, using data routinely collected on hospital wards, during thousands of nursing shifts."

Deputy project lead is Dr Jim Briggs, director of the University of Portsmouth's Centre for Healthcare Modellling and Informatics, who brings expertise on clinical outcome modelling.

In partnership with the Clinical Outcomes Research Group at Portsmouth Hospitals NHS Trust (PHT), the researchers will gather anonymised information from 32 general inpatient wards across 100,000 shifts. It will use data on nurse staffing levels, combined with vital signs observations and information on the outcome of patients' treatments.

Debra Elliott, Deputy Director of Nursing at PHT, says: "Patient care and patient safety are at the heart of everything we do, and we are delighted to be working with the University of Southampton on this very valuable research.

"Our participation will enable us to look in unprecedented detail at how staffing levels can impact on patients, and this will be an invaluable learning experience."

Previous studies have relied on nurses to report the care they missed. This research aims to be more accurate by using data directly from ward records. Data will be derived from a number of sources including nurses' handheld devices, a cardiac arrest database, intensive care unit admissions and laboratory records.

The study will conclude by estimating the staffing required on different types of hospital wards to ensure the observation of vital signs by nurses remains at an acceptable level. It will assess the costs and consequences of different staffing policies and give guidance on the importance and costs of different mixes of nursing skills to achieve consistent observation of patients and ultimately their safe care.

The authors aim to publish their findings in December 2017.