Weekend nurse ratio key to survival of stroke patients


A study has reported that it is not the frequency of ward rounds done by doctors, but the number of nurses on duty that affects the survival changes of stroke victims.

Researchers discovered that patients who were admitted to stroke units who had the lowest nurse ratio were at higher risk of death during the month after suffering a stroke. However, the ward rounds done over weekends by senior doctors appeared to make no different to the death rate.

The PLoS Medicine research assessed data obtained from more than 100 British hospitals.

A large section of research suggests that patients who are admitted to hospitals during the weekend do not recover as effectively as those admitted during the week.

The researchers made use of data from 103 hospitals and noted the ratio of nurses to patients available in stroke units over the weekend. They also assessed whether ward rounds were done by senior doctors on Saturdays and Sundays.

It was found that wards where there is an average of 1.5 nurses to 10 patients, there was a higher death rate than those ward where there were three nurses to 10 patients.

Scientists calculated that if the nurse ratios were increased to three nurses to 10 patients, it was possible to prevent one death for every 25 admissions.

They discovered that most wards were visited by senior doctors five days in each week and about 50% provided consultant rounds seven days per week. They found no change in the death rates between these two groups of doctors.

The research did not include the reasons for these trends, however, there is speculation that certain aspects of the care given by nurses, such as focus on hydration and nutrition could have a massive impact on survival after stroke.

The leader of the research from King’s College London, Dr Benjamin Bray, said that he considers the role of stroke doctors to be extremely important, but it is not right to measure the risk of death when considering the impact of their care provision. He said doctors play an important role in helping people return home quicker and in the speed of recovery. However, a different study would have to be done to measure the impact this has.

Dr Bray suggested that hospital should take the results of this study into account when looking at staff levels. He added however that it would be necessary to do further research targeted at the number of times patients were attended to by doctors and nurses as that would provide better insight into the intricacies involved.

The Royal College of Nursing’s Dr Peter Carter stated that the fact that mortality rates for stroke patients is higher at weekends when the staff levels are normally lower, is totally unacceptable. He said to increase the level of care in the NHS, an investment in the nursing workforce needs to be done. He added their concern that this is not occurring and said that there is much more that should be done to provide safe staffing levels in all health settings.

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