Nurse caseload, education impacts mortality rates

Mortality rates after common surgical procedures decrease dramatically if patients receive treatment in hospitals where nurses have managable workloads and hold bachelor's degrees, according to a study published in The Lancet.

Researchers from the University of Pennsylvania School of Nursing in Philadelphia and Catholic University of Leuven in Belgium surveyed 26,516 nurses and studied 422,730 surgical patients who underwent hip or knee replacement, appendectomy, gall bladder surgery and vascular procedures in 300 hospitals across nine European countries. 

Every one patient increase in patient-to-nurse ratios led to a 7 percent rise in death, according to the research. And hospitals saw a 7 percent mortality decrease for every 10 percent increase in the number of nurses hired who had bachelor's degrees.

Patients treated in hospitals where 60 percent of nurses had bachelor's degrees and cared for an average of six patients had nearly one-third lower risk of death after surgery than patients in hospitals where 30 percent of nurses had bachelor's degrees and cared for an average of eight patients each.

The research reflects findings from a 2013 U.S. study that showed an average reduction of 2.12 deaths per 1,000 hospital patients for every 10 percentage-point increase in nurses holding a baccalaureate degree in nursing. 

Nurse staffing cuts to save money could adversely affect patient outcomes, researchers said, emphasizing that nurses who earn advanced degrees could reduce preventable hospital deaths.

"Our results suggest that the assumption that hospital nurse staffing can be reduced to save money without adversely affecting patient outcomes may be foolish at best, and fatal at worst," Linda H. Aiken, Ph.D., professor of nursing and sociology, and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania, said in a statement.

Higher education can help nurses land jobs too. More hospitals require new hires have a bachelor's degree in nursing and almost 80 percent percent of healthcare employers now express a strong preference for BSN program graduates, FierceHealthcare previously reported. 

To learn more:
- here's the study
- read the statement