National Nursing Research Unit say 1:8 nurse to patient ratio is itself a red-flag

Researchers at the National Nursing Research Unit (NNRU), King’s College London, responded this morning to the release of draft NICE guidelines around safe staffing for nursing in adult inpatient wards in acute hospitals. 

Professor Anne Marie Rafferty, of the NNRU and UK PI on the RN4Cast study said , “We’re glad that the strength of the research evidence on nurse staffing – including our own RN4CAST research study – is recognised in the draft guidance from NICE.  The RN4Cast study (published in the Lancet) showed that for every additional patient a registered nurse cares for, the chances of dying increase by 7%. Poor staffing levels (more than 8 patients per registered nurses) is associated with a significantly greater risk of harm. Prof Linda Aiken, of the University of Pennsylvania, who spoke last week at the King’s Health Partners Nursing and Midwifery Conference 2014, and who was Scientific Director of the RN4Cast study, highlighted the significant variation in nursing numbers across NHS services (as shown in the RN4Cast nurse survey report), as well as drawing attention to the long term underinvestment in the nursing workforce in the UK, when compared to other countries in Europe. These are both issues that still need to be addressed.”

Jane Ball, Deputy Director of NNRU said “NICE’s suggestion of ‘red flag’ warnings is key. In my view 1:8 is itself a red flag – a level of staffing that can never be regarded as sufficient on acute hospital wards, given the acuity of patients and rapid turnover that has become the norm. But this is on a continuum, and is not a dividing line between ‘’good’ and ‘bad’ care. The more patients per RN the less time nurses have to deliver care; our research shows that on wards with more than 6 patients per RN, the amount of care left undone is significantly increased.”