RCN Northern Ireland

Community resuscitation strategy for Northern Ireland

The RCN has submitted its response  to a DHSSPS consultation on a community resuscitation strategy  for Northern Ireland. The strategy aims significantly to increase the number of people with CPR skills in order to provide assistance to people who suffer an out-of-hospital cardiac arrest, thus increasing their chances of survival. In its response, the RCN welcomes the draft strategy but makes a number of suggestions for strengthening it, particularly in respect of securing ownership within communities.

Nursing workload and education affects patient mortality, according to study

Patients are more likely to die after common surgical procedures when they are cared for in hospitals with heavier nurse workloads and fewer nurses educated to degree level, according to research published in The Lancet this week. The study findings, derived from more than 420,000 patients in 300 hospitals across nine European countries, indicate that each additional patient added to a nurse’s workload increases by 7% the chance of surgical patients dying within 30 days of admission. A 10% increase in the proportion of nurses holding a degree is associated with a 7% decrease in the risk of death.

The research was led by Professor Linda Aiken from the University of Pennsylvania School of Nursing. She said:

“Our findings emphasise the risk to patients that could emerge in response to nurse staffing cuts under recent austerity measures, and suggest that an increased emphasis on education for nurses could reduce hospital deaths”.

Nurse staffing and education levels varied widely both between countries and between hospitals within each country. The average patient-to-nurse ratio varied from 12.7 in Spain and 10.8 in Belgium to 6.9 in Ireland and 5.2 in Norway. In Spain and Norway, all nurses were educated to degree level compared with an average of just 10% in Switzerland and 28% in England. The findings suggest that patients have the highest risk of death after surgery in hospitals where nurses with lower levels of education care for more patients. For example, in hospitals where nurses care for an average of six patients each, and the proportion of nurses with degrees is 60% or greater, the risk of hospital deaths would be almost 30% lower than in hospitals where nurses care for an average of eight patients and in which only 30% of nurses have degrees.

Professor Aiken continued: “Our data suggest that a safe level of hospital nursing staff might help to reduce surgical mortality, and challenge the widely held view that nurses’ experience is more important than their education”.

RCN Chief Executive & General Secretary Dr Peter Carter said: “Compassion and caring will always be at the heart of nursing practice and nurse training".

However, the demands of modern health care mean that this must be backed up by a higher level of education so that patients, who often have complex needs, receive skilled and compassionate care. Modern medicine means that a nurse’s role is far more technical and requires complex decision-making, which demands a degree level education as well as the practical experience which currently makes up at least half of a nursing degree. What this research has demonstrated is that this can have a very real impact on patient mortality, which must be the top priority of everyone in the health service.” The survey includes data from England and the Republic of Ireland but not from Scotland, Wales or Northern Ireland.