Key to Stroke Survival? Nurse Staffing
HealthMay 09, 2017

Key to stroke survival? Nurse staffing

Better nurse staffing, said the study leader, was a "very clear and consistent predictor of stroke survival."

As the fifth highest cause of death in the U.S., it’s important for facilities and clinicians to be able to provide immediate and effective care for stroke patients.

Hospitals looking to improve their stroke survival rates may want to take a good, hard look at their nurse-to-patient ratios, suggests a recent study in the journal Age and Ageing.

The study, which included 2,388 patients in acute stroke units, found the best predictor of patient survival (after controlling for individual patient factors like age, blood pressure, and stroke severity) was having an optimal number of nurses on staff to provide patient care.

“We might expect more obvious aspects of healthcare to have a greater impact on survival, such as having a team to support early hospital discharge or the proportion of acute and rehab beds on the unit,” lead author Phyo Myint, MD, University of Aberdeen, told Nursing Times.

“Instead, we found that, when controlling for other variables, an increasing nurse-to-patient ratio has a substantial effect on reducing likelihood of death after stroke. This proved to be a very clear and consistent predictor of stroke survival.”

The difference a nurse can make

The investigation, which spanned 8 hospitals in England, was conducted by the University of Aberdeen along with the University of East Anglia.

“The study aimed to describe the regional variation in stroke mortality and to identify the characteristics of the services that were associated with better outcomes after accounting for case-mix differences and individual prognostic factors in a mostly rural population,” researchers explained.

According to the study, higher levels of nurse staffing were consistently linked with mortality outcomes. In fact, an increase of just one trained nurse for every 10 beds was linked with as much as a 28% drop in 30-day mortality and a 12% drop in 1-year mortality.

“Nursing staffing levels have been previously shown to be linked to patient outcome in general patient population as well as in stroke,” the researchers wrote.

“The current study,” they added, “has furthered this knowledge and provides new evidence that higher trained nursing staffing levels are associated with better mortality outcome up to 1-year post stroke.”

A lesson worth sharing

While the findings probably won’t come as a shock to many nurses, Dr. Myint told Nursing Times the results came as a surprise to him.

Not so much for Amanda Cheesley, RN, of the Royal College of Nursing, though. She noted that the study simply follows in the footsteps of others before it and further reinforces a clear link between adequate RN staffing and patient safety.

“It once more highlights the vital difference specialist nurses can make,” said told Nursing Times. “Too often, senior and specialist nursing posts have been cut to save money, but their expertise and experience has a measurable positive impact.”

Perhaps Dr. Myint’s initial surprise provides further “evidence” for nurses: No matter what nurses intuitively understand, speaking up for optimal nurse staffing is never wasted breath. Even high-level decision-makers may be ignorant of its effect on patient outcomes. And, at the end of the day, it just might save patient lives.

Looking for further information on how to enhance your organization’s stroke care?  The Lippincott Professional Development Collection institutional competency software includes a robust program set of 20 CE-accredited online courses on stroke disease-specific care that were co-developed in partnership with JCR (Joint Commission Resources). 

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