Nurses: (+) training (-) workloads = (-) mortality

A few months ago, Mireia Subirana, Director of Care at "Consorci Hospitalari de Vic" explained in a post the results of her doctoral thesis that can be summarized as: "more nurses and more training (in hospital wards) was associated with better clinical outcomes". Following this thread, The Lancet has just published the results of a retrospective observational study that has explored whether the nurses training levels and workload ratios could influence the mortality of patients admitted for medium complexity scheduled surgery.

It’s an important work undertaken in 300 hospitals in 9 European countries by surveying 26.516 nurses and analysing 422.730 hospitalization surgical episodes. Despite the expected methodological difficulties of a project of this nature, it can be considered as a rigorous study.

Impact of nurse staffing on clinical outcomes

In preparing this post, I invited Mireia Subirana, nurse and Director of Care Department at Hospital de  Vic (Catalonia), to present the contents of her doctoral thesis. It’s not a common occurrence for any nurse to get a doctor degree (University of Leeds). She now has a PhD degree and is a Fellow of the European Academy of Nursing Science.

But Subirana has not only been invited to praise her professional and academic career, but because I think it's worth explaining at exactly what point her research is at, having raised a hypothesis that affirms that if nurses from the hospital wards are well educated and the plans are well sized, this may have an impact on clinical outcomes of hospitalised patients. 

In the last ten years, research has established and endorsed the relationship between nurse staffing characteristics and clinical outcomes of hospitalised patients and thus objectifies the contribution of nurses in the care process. It remains to be found how this relationship is established, and the mechanisms that articulate it. This work, with a realistic methodological approach, identifies key factors in the process of care (monitoring, clinical trial, the level of training, experience and the tasks that they have not been able to do) along with the characteristics that define magnetic hospitals are articulated as possible mechanisms that could explain the impact of nurse staffing on patient outcomes.