Investing in professional nurses still pays off in hospitals
17 November 2016 - Higher mortality rates, more complications after routine surgery, and lower patient satisfaction. These are the consequences when hospitals replace professionally qualified nurses with lower skilled caregivers. An international team of researchers highlights the risks of this practice, which is increasingly common in the United States and the United Kingdom.
In hospitals in the United States and the United Kingdom, nurses are more and more frequently replaced with so-called ‘nurse assistants’, who are not professionally qualified and therefore less expensive. This cost-reducing measure has detrimental effects, warns Professor Walter Sermeus from the Leuven Institute for Healthcare Policy (LIHB).
“Mortality rates are higher in hospitals that employ more lower skilled caregivers,” says Professor Sermeus. “These hospitals also get lower patient ratings, and nurses are less positive about the quality and the safety of care.”
In collaboration with American and British researchers, Professor Sermeus collected and analysed the data of 275,519 patients in 243 Belgian, British, Finnish, Irish, Spanish, and Swiss hospitals.
“We focused on patients who had undergone routine surgery such as a hip replacement or the removal of their appendix. With this type of surgery, you expect very few complications. But in hospitals that employ a larger number of lower skilled caregivers, these interventions cause more problems. This is alarming.”
Mortality rates are higher in hospitals that employ more lower skilled caregivers.
Furthermore, the American and British efforts to save money are not cost effective. For one thing, more patients have to be readmitted due to complications. “If you replace professionally qualified nurses with cheaper and lower skilled staff, you get problems. This is not completely unexpected, but still, our findings show that financial considerations sometimes overplay quality concerns.”
“In Belgium, the situation is not problematic yet,” says Professor Sermeus. “Nurses make up 74% of the total number of caregivers in Belgian hospitals, which is one of the highest percentages in Europe. Extending the professional bachelor’s programme in nursing to four years to meet the requirement of the European Professional Qualification Directive will contribute to the quality of care and patient safety. And these should remain the priority, even in times of austerity.”
Click here to read the study in BMJ Quality & Safety (open access)