Stressed caregivers influence the mortality rate

Death rate influenced by caregiver stress

03/03/2014

According to one study, workload, stress and training of caregivers affect the mortality rate in hospitals. Even if Germany was not taken into account in the investigation, it looks at both points nationwide rather bad.

University degree influences death rate
Patients are better off in a hospital the more nurses there hold a university degree. There, significantly fewer patients die after common operations than in clinics with less well-trained nurses. This results from the evaluation of data from 300 hospitals in nine European countries, which in the journal „The Lancet“ has been published. According to the study, the number of patients cared for by a single sister also influences mortality from the clinic.

Death rates are generally low
Linda Aiken's international research team had evaluated data from more than 420,000 patients over 50 years of age who were in hospital for a surgical procedure. These were patients who had had a knee or hip replacement, an appendectomy or a vascular surgery. Death rates were generally low at one to 1.5 percent in the countries surveyed. However, there were some extreme fluctuations between individual clinics in one country.

Researchers did not receive data from Germany
According to first-person author Linda Aiken of the University of Pennsylvania School of Nursing (Philadelphia, Pennsylvania), according to press reports, Germany was not one of the countries studied because the scientists were unable to provide information on the mortality rate in the clinics. Data came from Belgium, Great Britain, Finland, Ireland, Norway, Spain, Sweden, Switzerland and the Netherlands.

The more patients per sister the higher the mortality rate
In the study, the researchers linked the death rates with the training of nurses and their workload. They took into account the individual risk of death of patients, which can be influenced by, among other things, age, sex, type of intervention and underlying diseases. In addition, they included details of the respective clinics in their analysis, such as the technical equipment of the hospital. The researchers came to the conclusion that with each patient a nurse needs to take care of, the risk of a patient dying within 30 days of admission increases by seven percent. On the other hand, the risk of death decreases by seven percent if the proportion of nurses with a university degree increases by ten percent.

German nurses without university degree
The results are also highly relevant for Germany, says Linda Aiken. A previous study in 49 German hospitals showed that no nurse has a university degree and thus Germany is a real outlier compared to other European and other developed countries. In addition, there would be more patients for each nurse in this country than in most other nations. This study was published last year in the „International Journal of Nursing Studies.“

Changed requirements for hospital staff
„The data of the current studies do not surprise us“, said the managing director of the German professional association for foster occupations (DbfK), Franz Wagner, according to press reports. „We believe that there is a similar trend in Germany as well.“ Today, demographic change is putting very different demands on hospital staff. The many chronically ill patients would need more intensive care and counseling to deal with their illness. Nurses are much more likely to recognize complications or structural errors in care if they were academically trained. As a rule, nurses in Germany are trained at vocational schools or nursing schools. So far, there is no purely university education in Germany, but at the model level there are currently dual training courses in cooperation with some universities.

Chronic lack of care in Germany
The fact that not everything runs smoothly in German hospitals is now also reflected in the chronic lack of care, which was partly caused by the massive job cuts. This not only leads to an overburdening of the employees, but it also becomes increasingly a risk for the patients. The problems are homemade because, since 1996, 50,000 full-time jobs have been reduced despite increasing work density and steadily rising numbers of patients in German hospitals. (Sb)