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Nurse staffing levels linked to patient satisfaction

January 11, 2018

PHILADELPHIA, PENNSYLVANIA & LONDON, ENGLAND (January 11, 2018) - Satisfaction with care in hospitals declines when patients believe there are not enough nurses on wards, according to a new study based on the NHS Inpatient Survey published in the BMJ Open.

Only 14 per cent of patients who reported there was never or rarely enough nurses on the hospital ward rated their care as excellent, while 57 percent of patients who reported there were usually enough nurses rated their care as excellent.

The study, led by researchers from the University of Pennsylvania, University of Southampton, and King's College London, also showed that only 60 per cent of the 66,348 patients responding to the NHS survey reported that there were usually enough nurses available to provide their care. One in 10 patients surveyed said there were never or rarely enough professional nurses during their hospital stay, the study has shown.

The internationally renowned research team say that their findings show that it is the availability of qualified registered nurses in hospitals that affects patient satisfaction most.

"The often repeated narrative suggesting that quality deficits in hospitals are due to 'uncaring' nurses is not supported by evidence from the NHS's own survey," says author Linda Aiken, PhD, RN, Director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania. "Patients value nurses so much that when nurses are in short supply, patients' overall ratings of their hospitals decline sharply."

The study shows that missed nursing care that is common when there are too few nurses on duty contributes to patients' low ratings of their hospitals.

Professor Peter Griffiths, from the University of Southampton, said: "The variation in nurse staffing levels between different NHS hospitals is huge. When there aren't enough professional nurses, things get missed, patients notice, and this affects their confidence in the quality of the hospital and the care they receive."

"England has one of the lowest percentages among European countries of professional nurses at the bedside already. We know that 65 per cent of nurses in hospitals in England say that high workloads prevent them from spending enough time comforting patients while 52 per cent of nurses say they don't have enough time to teach patients and their families how to manage after hospital. But having more staff on the wards, who have limited qualifications is not enough - the NHS needs to focus on achieving safe registered nurse staffing levels as a means to achieve better outcomes including improving patients' satisfaction with their care."

The study shows that patients' confidence in doctors and nurses is equally important in whether they rate the hospital care as excellent.

"Shoring up nurse staffing as well as medical staffing is warranted to improve quality of care," said Professor Anne Marie Rafferty, DPhil (Oxon) RN, from the Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London.

''Patient perception is an important barometer of quality of care and confidence in the NHS. The widening gap between demand and capacity is reflected in missed care, which in turn is associated with poor nurse staffing and poor hospital environments. Improving nurse staffing in NHS hospitals holds promise for improving patient satisfaction''.

This large study is the latest in a series of studies and commissioned reports on uneven quality of care in NHS hospitals in England pointing to the immediate need for increasing the number of funded positions in NHS hospitals for highly qualified professional nurses.
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About the University of Pennsylvania School of Nursing

The University of Pennsylvania School of Nursing is one of the world's leading schools of nursing. For the second year in a row, it is ranked the #1 nursing school in the world by QS University, and has four graduate programs ranked number one by U.S. News & World Report, the most of any school in the United States. Penn Nursing is consistently among the nation's top recipients of nursing research funding from the National Institutes of Health. Penn Nursing prepares nurse scientists and nurse leaders to meet the health needs of a global society through research, education, and practice. Follow Penn Nursing on: Facebook, Twitter, LinkedIn, Instagram & YouTube.

About the University of Southampton

Through world-leading research and enterprise activities, the University of Southampton connects with businesses to create real-world solutions to global issues. Through its educational offering, it works with partners around the world to offer relevant, flexible education, which trains students for jobs not even thought of. This connectivity is what sets Southampton apart from the rest; we make connections and change the world. http://www.southampton.ac.uk/

King's College London

King's College London is one of the top 25 universities in the world (2016/17 QS World University Rankings) and among the oldest in England. King's has more than 29,600 students (of whom nearly 11,700 are graduate students) from some 150 countries worldwide, and some 8,000 staff. King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF), eighty-four per cent of research at King's was deemed 'world-leading' or 'internationally excellent' (3* and 4*).Since our foundation, King's students and staff have dedicated themselves in the service of society. King's will continue to focus on world-leading education, research and service, and will have an increasingly proactive role to play in a more interconnected, complex world. Visit our website to find out more about Vision 2029, King's strategic vision for the next 12 years to 2029, which will be the 200th anniversary of the founding of the university. For further information about King's, please visit http://www.kcl.ac.uk/newsevents/About-Kings.aspx

University of Pennsylvania School of Nursing

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