Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care (15 November 2016)

Summary

This cross-sectional study in BMJ Quality & Safety examines the association of hospital nursing skill mix with patient mortality and quality of care. The study analysed patient discharge data, hospital characteristics and nurse and patient survey data from adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland.

The authors found that a bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. They suggest that having a higher proportion of assistive nursing personnel without professional nurse qualifications reduces the skill mix and may:

• contribute to preventable deaths
• erode quality and safety of hospital care
• contribute to hospital nurse shortages.