Patients are more likely to die on wards staffed by a high number of temporary nurses, a study has found.
Researchers say the findings, published in the Journal of Nursing Scholarship, are a warning sign that the common practice by many hospitals of relying on agency nurses is not a risk-free option for patients.
The University of Southampton study found that risk of death increased by 12 per cent for every day a patient experienced a high level of temporary staffing – defined as 1.5 hours of agency nursing a day per patient.
For an average ward, this increased risk could apply when between a third and a half of the staff on each shift are temporary staff, according to Professor Peter Griffiths, one of the study’s authors.
He told The Independent: “We know that patients are put at risk of harm when nurse staffing is lower than it should be.
“One of the responses to that is to fill the gaps with temporary nursing staff, and that is an absolutely understandable thing to do, but when using a higher number of temporary staff there is an increased risk of harm.
“It is not a solution to the problem.”
The UK currently has more than 44,000 nursing vacancies across the NHS, with hospitals often using temporary staff to fill the gaps.
Nurse staffing has been a major subject of debate during the general election campaign, with the Tories promising 31,000 new nurses and efforts to retain 19,000 existing staff. Labour has pledged to re-instate student nurse bursaries.
The NHS is drawing up a national workforce plan, but a leaked draft suggested that the UK could still face a shortage of 20,000 nurses by 2024.
The research team from the university’s school of health sciences looked at data for 138,133 patients who were admitted to a large south of England hospital between April 2012 and April 2015.
While the study could not say what caused the increased risk, a clear association was found between levels of temporary staff and deaths. It looked at the levels of staff measured as hours per patient, per day, and accounted for other risks and general staffing levels.
It found the use of temporary staff was common, with three quarters of days involving the use of temporary nurses.
The paper said the “hazard of death was increased by 12 per cent for every day a patient experienced high levels (1.5 hr or more per day) of temporary staffing”.
The study also found a link with the use of temporary nurse assistant staff, with the risk of death increasing by 6 per cent on days when patients had more than 0.5 hours of temporary assistant staffing.
Professor Griffiths said that there may be many reasons why there was an increased risk, including staff not being familiar with the ward or processes, and staff working extra hours – known as “bank” shifts – and potentially being overworked as a result.
Another reason, he added, could be that the wards were culturally “bad” because of poor leadership and consequently had a lot of vacancies.