Stroke Death Rates 'Higher On Understaffed Wards'

Higher Stroke Mortality Rate Recorded On Wards With Fewer Nurses


Nurse staffing numbers have a direct impact on stroke death rates, according to new research led by King's College London. 

Published in the journal PLOS Medicine, the study discovered the correlation after examining the impact of weekend staffing numbers on patient outcomes. Researchers analysed data from a total of 56,666 patients with stroke admitted between June 2011 and December 2012.

Dr Benjamin Bray of King's College London and the Royal College of Physicians found that stroke patients admitted to hospitals with the lowest ratios of registered nurses to patient beds had higher mortality rates.
There was also found to be a close link between the number of nurses on a given ward in the week and at the weekend. 

When confounding factors were taken into account, the estimated adjusted 30-day mortality risk for patients on a stroke unit with 1.5 nurses for every ten beds stood at 15.2 per cent, compared to 11.2 per cent when there were three nurses per ten beds - representing one additional death for every 25 admissions.

Perhaps surprisingly, mortality appeared to be unaffected by the number of rounds made by specialist stroke physicians. No difference was discovered between hospitals where specialist rounds took place seven times a week and those where rounds were less frequent.

Interpreting the results, the authors declared that the lack of a connection between daily physician rounds and mortality rates could be explained by the fact that most wards not carrying out rounds seven times a week instead did so five times a week.

"The difference in patients' exposure to the frequency of physician rounds was therefore small," the report stated.

It added: "By contrast, weekend nursing ratios were strongly associated with mortality outcomes, not only for patients admitted on a weekend but also for those admitted on a weekday."

Expert Opinion
We see time and time again the impact under-resourced wards can have on patient safety, particularly over the weekend.

“It is vital patients have access to the best possible care 24 hours a day, seven days a week, regardless of when they need treatment.

“Stroke patients often have complex care needs due to the nature of brain injuries. NHS Trusts must invest more in ensuring that there is an acceptable number of nurses available at all times, so that patients care needs are met and they have the best possible chance of recovery.”
Julie Lewis, Partner