Is one nurse per eight patients enough?

Nurse image

Staffing level advice issued to stop compromised care

The National Institute for Health and Care Excellence (NICE) has released new guidelines on safe nursing staffing levels, suggesting that having more than eight patients per nurse on a ward during the course of the day should act as a trigger to investigate patient safety.

If one nurse is caring for more than eight patients then care should be double checked to ensure it is not being compromised in any way, according to the health body. NICE also presented a set of ‘red flag’ events that should raise concern, for example, delays in patient’s receiving pain relief or patient’s not being helped to visit a bathroom.

With both patients and nurses having the power to raise these red flags, they must then be investigated and explanations provided. The government have labelled the NICE recommendations as a “major step forward”. 

More nurses needed?

Previously, hospitals were able to set up their own nurse staffing levels, however ministers requested NICE investigate after it was flagged during the public inquiry into Stafford Hospital. NICE have estimated that implementing this advice could cost approximately £200 million.

Prof Gillian Leng, deputy chief executive of the National Institute for Health and Care Excellence (NICE), told BBC News “Safe staffing is more complex than setting a single ratio. The emphasis should not just be on the available number of staff, it should be on delivering safe patient care and making sure that hospital management and nursing staff are absolutely clear on best practice to do this. The reason why there is no single one-to-eight figure is because that will be seen as the figure that should be applied across all wards where we know that one to eight is not going to be enough in many scenarios. A single figure is not appropriate if we want to deliver the right level of care for patients.”

Peter Carter, general secretary of the Royal College of Nursing, said “Nursing staff have long recognised the importance of safe staffing levels and consistently provided evidence of the danger to patients where there are too few staff. It is good to see that this is now being recognised across the NHS.”