Nurse staffing levels & missed vital signs
Research type
Research Study
Full title
Nurse staffing levels, missed vital signs observations and mortality in hospital wards: modelling the consequences and costs of variations in nurse staffing and skill mix. Retrospective observational study using routinely collected data
IRAS ID
168255
Contact name
Peter Griffiths
Contact email
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
The quality of nursing care - and the potential for inadequate nursing care to do patients great harm - has emerged as a factor in several reports into failings in NHS hospitals. Failing to ensure adequate nurse staffing has been associated with poor care and preventable deaths. Recent research has explored “missed nursing care”, defined as nursing care that was needed but not done, as a key factor leading to negative patient outcomes. Missed opportunities to observe and act on deterioration of the patient’s condition are thought to be important factors in preventable hospital deaths.
Previous studies have relied on nurses to report the care they missed. This may not be entirely accurate. This study aims to explore how nurse staffing levels are related to missed or delayed vital signs observation (measurements of blood pressure, pulse and respirations) using information recorded in a clinical information system. The study will also look at the relationship between staffing levels and possible consequences of missed observations in terms of cardiac arrest calls, unanticipated admission to intensive care and death.
This study will use information about ward and shift level nurse staffing, vital signs observations and patient outcomes that are routinely recorded, from all acute general inpatient wards in Portsmouth Hospitals NHS Trust (PHT). Relationships between nurse staffing levels and outcomes will be explored using statistical models to examine how much the risk of missing a set of observations is increased for every additional patient cared for by a nurse. These results will be used to estimate staffing required on different wards to achieve satisfactory levels of compliance with vital signs observations. The study will give guidance on the relative importance and costs of different nursing skill mixes and staffing levels in achieving consistent observations and safe care.REC name
East Midlands - Leicester South Research Ethics Committee
REC reference
15/EM/0099
Date of REC Opinion
19 Feb 2015
REC opinion
Favourable Opinion