Patient Satisfaction Linked to Number of Nurses on Staff

By Jane Farrell

Hospital patients’ satisfaction with their care drops when the patients believe that staffing levels of nurses are too low, according to a new study conducted by researchers from the University of Pennsylvania, the University of Southampton, UK, and King’s College, London.

The study results were based on the British NHS (National Health Service) Inpatient Survey and were published in the BMJ Open. NHS is the name of the public health service in the UK.

Just 14 per cent of patients who reported there were never or rarely enough nurses on the hospital ward rated their care as excellent, while 57 percent of patients who reported there were usually enough nurses rated their care as excellent.

The study also showed that only 60 per cent of the 66,348 patients responding to the NHS survey reported that there were usually enough nurses available to provide their care. One in 10 patients surveyed said there were never or rarely enough professional nurses during their hospital stay.

The investigators said that the findings indicate that it is the availability of qualified registered nurses in hospitals that most affects patient satisfaction.

“The often repeated narrative suggesting that quality deficits in hospitals are due to ‘uncaring’ nurses is not supported by evidence from the NHS’s own survey,” said author Linda Aiken, PhD, RN, Director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania. “Patients value nurses so much that when nurses are in short supply, patients’ overall ratings of their hospitals decline sharply.”

Professor Peter Griffiths, from the University of Southampton, said: “The variation in nurse staffing levels between different NHS hospitals is huge. When there aren’t enough professional nurses, things get missed, patients notice, and this affects their confidence in the quality of the hospital and the care they receive.”

“England has one of the lowest percentages among European countries of professional nurses at the bedside already. We know that 65 per cent of nurses in hospitals in England say that high workloads prevent them from spending enough time comforting patients, while 52 per cent of nurses say they don’t have enough time to teach patients and their families how to manage after hospital [stays]. The NHS needs to focus on achieving safe registered nurse staffing levels as a means to achieve better outcomes, including improving patients’ satisfaction with their care.”

The study shows that patients’ confidence in doctors and nurses is equally important in whether they rate the hospital care as excellent.

“Shoring up nurse staffing as well as medical staffing is warranted to improve quality of care,” said Professor Anne Marie Rafferty, DPhil (Oxon) RN, from the Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London.

“Patient perception is an important barometer of quality of care and confidence in the NHS. The widening gap between demand and capacity is reflected in missed care, which in turn is associated with poor nurse staffing and poor hospital environments. Improving nurse staffing in NHS hospitals holds promise for improving patient satisfaction.”