Newspaper article International New York Times

Nurse Education Level Affects Death Rates, Study Says ; Decrease in Mortality Reported with Increase in Degree-Holding Caregivers

Newspaper article International New York Times

Nurse Education Level Affects Death Rates, Study Says ; Decrease in Mortality Reported with Increase in Degree-Holding Caregivers

Article excerpt

The study found that each 10 percent increase in the percentile of the nursing staff with a bachelor's degree was associated with a 7 percent decrease of mortality.

In a small sunlit classroom at the Radboud University teaching hospital here, a group of nurses carefully examined computer- generated cardiographs one day this month, practicing their diagnostic skills. The 23 nurses were enrolled in one-year specialized courses to develop their skills in intensive and emergency care.

The nurses were a mixed group, including a range of ages, backgrounds, experience levels -- and qualifications.

About half of the class had university degrees in nursing. The others had qualified through vocational training.

According to a recently published study, that difference in particular has a significant impact on patient death rates in European hospitals.

Results of the Europe-wide study of hospitals and nurses, published in the Lancet medical journal, highlighted two factors that correlated with variations in patient mortality in surgical wards. One was the number of patients per nurse. The other was the percentage of the nursing staff educated at a university to bachelor's degree level.

The study comes at a sensitive time. Across Europe debate is raging over austerity policies and public spending cuts, including cuts in hospital funding. The study may also fuel debate on the role of nursing in modern health care. Training and employing university- qualified nurses is a high-cost option and runs counter to established practice in German-speaking and Eastern European countries, where hierarchical systems look to nurses mainly to carry out the physical tasks of hospital care.

The study, by a consortium of European and American researchers, looked at patient files and nurses' qualifications at 300 hospitals across nine European countries. After adjusting for factors unrelated to the nursing staff -- for example, the severity of patients' illnesses -- it found that each 10 percent increase in the percentile of the nursing staff with a bachelor's degree (for example, from 50 percent to 55 percent) was associated with a 7 percent decrease of mortality among the associated patient group.

Patients covered by the study were aged 50 or older and admitted to a hospital for at least two days for common general, orthopedic or vascular surgery.

The researchers also found that for every one-patient increase in the number of patients per nurse there was an associated 7 percent increase in patient death rates. The mean ratio for the hospitals in the study was 8.3 patients per nurse, with national variations around the mean ranging from 5.2 patients per nurse in Norway to 12.7 in Spain.

The mean mortality rate in the patient target group across the nine countries was 1.3 percent. At the low end, participating hospitals in Sweden had a 1.0 percent mortality rate among the defined patients, while the institutions that participated in the Netherlands, Ireland, Norway and Switzerland had mortality rates closer to 1.5 percent.

The study mined data for 422,730 patients -- nearly everybody in the target age group admitted for surgery at participating hospitals in the Netherlands, Belgium, England, Ireland, Norway, Spain, Sweden and Switzerland. …

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