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Hospital death rate study reveals wide variations

Hospital death rates can be reduced by employing more Registered Nurses and the routine use of care maps or protocols, according to a study in the latest UK-based Journal of Advanced Nursing.

A research team from the University of Toronto and the Institute for Clinical Evaluative Sciences in Ontario, Canada, studied 46,993 patients admitted to hospital with heart attacks, stroke, pneumonia and blood poisoning.

They discovered that deaths within 30 days of admission varied considerably between the 75 hospitals in the study ranging from ten per cent to 28 per cent and averaging just under 17 per cent.

When they added in the survey results from 3,886 nurses at the hospitals - together with official discharge and death rates, population statistics and insurance plan data they discovered that a number of factors accounted for 45 per cent of the variation in death rates.

"Our research underlines the need for hospitals to look as carefully at staffing structures and care processes as they already do at accurate diagnosis and appropriate and effective interventions" says lead author Dr Ann Tourangeau.

19 variables were examined to gauge their effect on 30-day death rates. Key findings included:

  • A ten per cent increase in the proportion of Registered Nurses employed was associated with six fewer deaths per 1000 discharged patients.

  • The death rate also went down by nine per 1000 discharged patients when the number of Baccalaureate-prepared (university graduate rather than diploma qualified) nurses went up by ten per cent.

  • A ten per cent increase in adequate staffing and resources (as reported by nurses) was associated with 17 fewer deaths per 1,000 discharged patients.

"An important finding of our study was the effect that the routine use of care maps or protocols had on lowering 30-day death rates" adds Dr Tourangeau.

"A ten per ce
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Contact: Annette Whibley
wizard.media@virgin.net
Blackwell Publishing Ltd.
11-Jan-2007


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