Hospital wards ‘dangerously understaffed’, according to nurses survey

More than half of nurses think their ward or unit is dangerously understaffed, a Nursing Times survey revealed today.

Nearly six out of 10 (57%) described their ward as sometimes or always “dangerously understaffed”, the research showed.

Over three quarters (76%) said they had witnessed “poor” care in their ward or unit over the past year – of which nearly 30% said they see poor care regularly.

Ahead of the the publication of the public inquiry report into deaths at Mid Staffordshire Hospital, the magazine polled 600 of its readers across a range of issues including staffing, patient safety and NHS culture.

A majority of respondents said the ratio of patients to each nurse at their hospitals could compromise patient care.

More than eight out of 10 respondents said staffing on general medical wards in an acute hospital was at a ratio of eight patients to one nurse, or more.

And of these nearly half (44%) said the ratio was 10 or more patients per nurse.

A ratio of eight or more patients per registered nurse is associated with patient care on a ward regularly being compromised by short staffing, according to the Royal College of Nursing (RCN).

In addition, nearly half 43% of those who worked on general medical wards said the ratio of registered nurses to unqualified healthcare assistants was either 50:50 or worse, similar to ratios at Stafford Hospital, part of the Mid Staffs trust.
Prime Minister David Cameron meets nurses during a visit to Royal Derby Hospital last month. Prime Minister David Cameron meets nurses during a visit to Royal Derby Hospital last month.

The RCN recommends a ratio of 65% registered nurses to 35% non-registered nursing staff.

The inquiry into the Mid Staffs trust was commissioned in 2010 after a separate highly critical report by the Healthcare Commission the previous year revealed a catalogue of failings at Mid Staffordshire NHS Foundation Trust and said “appalling standards” put patients at risk.

Between 400 and 1,200 more people died than would have been expected in a three-year period from 2005 to 2008, the commission said.

In February 2010, an independent inquiry into events at the trust found it had “routinely neglected patients”.

It recently emerged that the trust has paid out more than #1 million in compensation to 120 victims of abuse or their families.
A patient helped by a nurse at Guys Hospital in London in 2011. A patient helped by a nurse at Guys Hospital in London in 2011.

Asked whether they thought there were more “Mid Staffs” out there, nearly half (46%) of survey respondents said they thought there were many trusts failing like Mid Staffs and 38% that there were a small number of trusts failing like Mid Staffs.

Meanwhile, around a third were not confident they could rule out a similar situation to that which occurred at Mid Staffs happening at their trust.

More specifically, 23% said they were “at risk” of a similar situation occurring at their trust and 12% that it was already happening at their trust – either in isolated parts of the organisation or across it.

In addition, the idea of “hourly rounding” that was promoted by Prime Minister David Cameron in January was not happening in nearly a third of general medical wards.

The practice involves nurses proactively visiting patients every hour to check on them rather than waiting to be called for assistance, but 31% said they were not aware of hourly ward rounds having been introduced at their trust.