Findings from a new study published this week have shown that nurses say they are having to “ration” care because of time pressures.
As part of the study, nurses were asked about “missed care” – meaning care that nurses deemed to be necessary, but which they were unable to do or complete because of insufficient time.
The aim of the study was to examine the nature and frequency of care left undone by nurses in NHS hospitals and to assess whether the number of missed care episodes is associated with nurse staffing levels and nurse ratings of the quality of nursing care and patient safety.
2,917 registered nurses working in 401 general medical/surgical wards in 46 general acute NHS hospitals in England were surveyed for the study between January and September 2010.
The results found that 86% of the 2,917 nurses asked said that one or more care activities had been left undone due to lack of time on their last shift. The areas that suffered most were:
- Talking to and comforting patients – cited by 66% respondents;
- Educating patients – cited by 52% of respondents; and
- Developing/updating nursing care plans – cited by 47% of respondents.
On average, nurses reported being unable to do or complete four activities. The number of patients per nurse was also shown to be significantly associated with the incidence of missed care.
Jane Ball, who led the research, was reported as saying:
“The study not only reasserts the connection between staffing levels and patient outcomes, but provides an indication of the scale of the staffing problems we face. Only the top 40% of hospital wards have registered nurse staffing levels that are sufficient to ensure a better level of provision – least chance of care being left undone. The majority of general medical/surgical wards have staffing levels that are insufficient to meet patient needs on every shift.”
The General Secretary of the Royal College of Nursing, Dr Peter Carter, said:
“These are depressing findings and unfortunately not surprising. When nurses are overloaded with tasks, and have extremely limited time to complete them, something has to give. We need to prevent poor care by making sure wards are well staffed, not just use poor care as an early warning sign.”
NHS England said, in response to the report, that the new Chief Inspector of Hospitals would be working closely with the Care Quality Commission to ensure that units met standards of care and that they were committed to ensuring that all patients receive compassionate and competent nursing care.
Although it is not unknown that nurses face various pressures within their work every day, it is unlikely that the public realise just how considerable these pressures are and how this impacts significantly on the care that is ultimately received. The findings of this study clearly show that nurses are essentially having to decide between which tasks can and can’t be done during their shift, making it inevitable that various areas of care will suffer.
Hospitals need to use the evidence of this report to ensure that wards are staffed sufficiently with the right mix of skills in order that they can provide the level of care required. However, with substantial budget cuts within the NHS an on-going difficulty, it remains to be seen how hospitals can successfully act on the findings.
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Danielle Young is an Associate in our specialist Medical Negligence team. Contact Danielle or another member of the team on 0800 024 1976 or via our online form and they will be happy to discuss our services with you.