Safe nurse staffing levels in acute hospitals
KCE Reports 325 (2019)
At the international level, it is generally accepted that patient safety in hospitals cannot be guaranteed when there are more than 8 patients per nurse. However, in Belgian hospitals, nurses have to look after 9.4 patients on average. That is already better than 10 years ago, when a study carried out by KU Leuven found that there was 1 nurse per 11 patients. But the current situation is still not acceptable, particularly because the intensity of care has increased over the past ten years, so patient safety is not guaranteed in many services in which KCE undertook the study, particularly in geriatrics (where, nearly 70% of the time, the patient/nurse ratio is above what is regarded as safe).
The nurses themselves are aware of the risks presented by this situation. Due to a lack of time, they are increasingly unable to perform the necessary care, particularly because they have to carry out numerous other tasks (serving meals, transporting patients within a hospital) which could just as easily be carried out by auxiliary nurses or non-medical staff.
Not only is this situation dangerous and/or uncomfortable for patients, but it also contributes to the increasing dissatisfaction of nurses: one in four is dissatisfied with their work, 36% run the risk of burnout, and 10% are even considering quitting the profession.
The study concludes with a number of recommendations, the first of which is that a maximum number of patients per nurse needs to be laid down by law, and that the necessary resources must be invested in order to improve the nurses’ working conditions and the safety of care. Swift elimination of clearly dangerous situations would require a staffing increase of 1,629 full-time equivalents, in other words an additional annual budget of nearly 118 million euro. In the longer term, and just for surgery, internal medicine, geriatrics, rehabilitation and paediatrics, a further 5,527 full-time nurses would be required, with an additional annual budget of more than 403 million euro.
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