NEWS
Employing more graduate nurses could save 3,500 lives each year By Sally Gillen and Kat Keogh Thousands of patients’ lives could be saved every year by employing more nurses with degrees, according to an eminent nurse academic involved in international research into possible links between nurse education and mortality rates. Anne Marie Rafferty, chair of nursing policy at the National Nursing Research Unit at King’s College London told Nursing Standard the research showed that around 3,500 lives could be saved across Europe by having more nurses with degree qualifications. The RN4CAST study, undertaken in nine European countries, looked at discharge data for 42,730 patients aged 50 and over who underwent common surgical procedures in 300 hospitals and compared mortality rates after 30 days. The researchers also asked 26,516 nurses to complete questionnaires about ward staffing and nurse education. They found that for every 10 per cent increase in nurses qualified to degree level, the likelihood of mortality
decreased by 7 per cent, while one extra patient on a nurse’s workload increased the likelihood of a patient dying within 30 days of admission by 7 per cent. Hospitals where 60 per cent of nurses had degrees and cared for an average of six patients each reduced mortality by 30 per cent, the researchers concluded. Professor Rafferty said that at the 30 English hospitals involved in the
EMPLOYERS NEED TO INVEST IN NURSES’ EDUCATION – Anne Marie Rafferty
study, the numbers of graduate nurses employed varied from 10 per cent to 49 per cent. ‘The two key messages from the research are that employers need to invest in the education of nurses, and better staffing makes a difference,’ she said. RCN general secretary Peter Carter said: ‘Modern medicine means that a nurse’s role is far more technical and requires complex decision making, which demands a degree-level
education as well as the practical experience that currently makes up at least half of the nursing degree.’ Since 2013, entry to the profession in the UK has been graduate-only. Meanwhile, University Hospitals Birmingham NHS Foundation Trust chief executive Dame Julie Moore has called on trusts to ‘over-recruit’ nurses to drive up the quality of patient care. The nurse has set a target of over-recruiting nursing positions by 10 per cent at her trust, and has urged others to follow suit. Dame Julie said that trusts should move away from a fear of going over their establishment, and concentrate on what is best for patients. A good candidate should never be turned away, she added, even if it means creating a new position for them. ‘You should be over-recruiting – and never allow a good person not to be appointed,’ Dame Julie told last week’s Florence Nightingale Foundation annual conference in London. ‘If you interview two good people for one staff nurse position, then employ them both.’
‘NHS SHOULD DISTINGUISH BETWEEN MISTAKES AND RECKLESSNESS’ Too often the NHS does not distinguish between honest mistakes made by staff and reckless action leading to harm, according to a consultant on patient safety. Speaking at the Florence Nightingale Foundation annual conference in London last week, Murray Anderson-Wallace said: ‘In health care we do not have a very sophisticated understanding of the difference between honest mistakes and reckless action. We conflate the whole lot and do not make any distinction.’ Mr Anderson-Wallace, an executive producer at Patient Stories, a social enterprise that helps people who have
NURSING STANDARD
experienced harm, spoke alongside James Titcombe, whose nine-day-old son died of sepsis at United Hospitals Morecombe Bay NHS Foundation Trust in 2008. Mr Titcombe said his family’s experience of complaining to the trust had been an ‘absolute nightmare’. ‘All people want is truth and reconciliation, and we were denied that,’ he said. A report by the parliamentary and health service ombudsman, published last week, upheld complaints by Mr Titcombe that the trust had failed to investigate adequately the circumstances that led to his son’s death.
Mr Titcombe has since left a job in the nuclear industry to become the national adviser on patient safety, culture and quality at the Care Quality Commission. ‘Health care is risky,’ he told delegates. ‘People make mistakes and sometimes they have tragic consequences. But if we talk about the consequences, we can inform people and we can reduce the chance of these things happening again.’ Guidance was issued to hospitals in England and Wales last month urging nurses and healthcare workers to apologise when things go wrong. To read the NHS Litigation Authority guide, go to tinyurl.com/nhsla-sorry march 5 :: vol 28 no 27 :: 2014 13
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Employing more graduate nurses could save 3,500 lives each year By Sally Gillen and Kat Keogh Thousands of patients’ lives could be saved every year by employing more nurses with degrees, according to an eminent nurse academic involved in international research into possible links between nurse education and mortality rates. Anne Marie Rafferty, chair of nursing policy at the National Nursing Research Unit at King’s College London told Nursing Standard the research showed that around 3,500 lives could be saved across Europe by having more nurses with degree qualifications. The RN4CAST study, undertaken in nine European countries, looked at discharge data for 42,730 patients aged 50 and over who underwent common surgical procedures in 300 hospitals and compared mortality rates after 30 days. The researchers also asked 26,516 nurses to complete questionnaires about ward staffing and nurse education. They found that for every 10 per cent increase in nurses qualified to degree level, the likelihood of mortality
decreased by 7 per cent, while one extra patient on a nurse’s workload increased the likelihood of a patient dying within 30 days of admission by 7 per cent. Hospitals where 60 per cent of nurses had degrees and cared for an average of six patients each reduced mortality by 30 per cent, the researchers concluded. Professor Rafferty said that at the 30 English hospitals involved in the
EMPLOYERS NEED TO INVEST IN NURSES’ EDUCATION – Anne Marie Rafferty
study, the numbers of graduate nurses employed varied from 10 per cent to 49 per cent. ‘The two key messages from the research are that employers need to invest in the education of nurses, and better staffing makes a difference,’ she said. RCN general secretary Peter Carter said: ‘Modern medicine means that a nurse’s role is far more technical and requires complex decision making, which demands a degree-level
education as well as the practical experience that currently makes up at least half of the nursing degree.’ Since 2013, entry to the profession in the UK has been graduate-only. Meanwhile, University Hospitals Birmingham NHS Foundation Trust chief executive Dame Julie Moore has called on trusts to ‘over-recruit’ nurses to drive up the quality of patient care. The nurse has set a target of over-recruiting nursing positions by 10 per cent at her trust, and has urged others to follow suit. Dame Julie said that trusts should move away from a fear of going over their establishment, and concentrate on what is best for patients. A good candidate should never be turned away, she added, even if it means creating a new position for them. ‘You should be over-recruiting – and never allow a good person not to be appointed,’ Dame Julie told last week’s Florence Nightingale Foundation annual conference in London. ‘If you interview two good people for one staff nurse position, then employ them both.’
‘NHS SHOULD DISTINGUISH BETWEEN MISTAKES AND RECKLESSNESS’ Too often the NHS does not distinguish between honest mistakes made by staff and reckless action leading to harm, according to a consultant on patient safety. Speaking at the Florence Nightingale Foundation annual conference in London last week, Murray Anderson-Wallace said: ‘In health care we do not have a very sophisticated understanding of the difference between honest mistakes and reckless action. We conflate the whole lot and do not make any distinction.’ Mr Anderson-Wallace, an executive producer at Patient Stories, a social enterprise that helps people who have
NURSING STANDARD
experienced harm, spoke alongside James Titcombe, whose nine-day-old son died of sepsis at United Hospitals Morecombe Bay NHS Foundation Trust in 2008. Mr Titcombe said his family’s experience of complaining to the trust had been an ‘absolute nightmare’. ‘All people want is truth and reconciliation, and we were denied that,’ he said. A report by the parliamentary and health service ombudsman, published last week, upheld complaints by Mr Titcombe that the trust had failed to investigate adequately the circumstances that led to his son’s death.
Mr Titcombe has since left a job in the nuclear industry to become the national adviser on patient safety, culture and quality at the Care Quality Commission. ‘Health care is risky,’ he told delegates. ‘People make mistakes and sometimes they have tragic consequences. But if we talk about the consequences, we can inform people and we can reduce the chance of these things happening again.’ Guidance was issued to hospitals in England and Wales last month urging nurses and healthcare workers to apologise when things go wrong. To read the NHS Litigation Authority guide, go to tinyurl.com/nhsla-sorry march 5 :: vol 28 no 27 :: 2014 13
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