Stressed caregivers: influencing the death rate

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Death rate influenced by caregiver stress

According to a study, workload, stress, and nursing training affect mortality rates in hospitals. Even if Germany was not taken into account in the investigation, it looks rather bad nationwide on both points.

University degree influences mortality rate The more nurses and nurses there are in higher education, the better off they are in a hospital. There, significantly fewer patients die after common operations than in clinics with less well-trained nurses. This emerges from the evaluation of data from 300 hospitals in nine European countries, which was published in the specialist journal "The Lancet". The study also found that the number of patients cared for by a single sister affected clinic death rates.

Death rates generally low The international research team led by Linda Aiken had evaluated data from a total of more than 420,000 patients over the age of 50 who were hospitalized for a surgical operation. It was about patients who had had a knee or hip replacement, an appendix operation or a vascular surgery. The death rates were generally low at one to 1.5 percent in the countries examined. However, there were sometimes extreme fluctuations between individual clinics in a country.

Researchers got no data from Germany As the first author Linda Aiken from the University of Pennsylvania School of Nursing (Philadelphia / Pennsylvania) reported in the press reports, Germany was not one of the countries examined because the scientists did not get any information on the death rate in the clinics could. Data came from Belgium, Great Britain, Finland, Ireland, Norway, Spain, Sweden, Switzerland and the Netherlands.

The more patients per sister, the higher the death rate. In the investigation, the researchers linked the death rates to the training of nurses and their workload. They took into account the patient's individual risk of death, which can be influenced, among other things, by age, gender, type of intervention and underlying diseases. They also included information about the respective clinics in their analysis, such as the technical equipment of the hospital. The scientists concluded that for every patient that a nurse needs to care for more, the risk of a patient dying within 30 days of admission increases by seven percent. On the other hand, the risk of death will decrease by seven percent if the proportion of nurses with a university degree increases by ten percent.

German nurses without a university degree The results are also highly relevant for Germany, says Linda Aiken. An earlier investigation in 49 German clinics showed that no nurse had a university degree and that Germany was a real outlier compared to other European and other developed countries. In addition, there would be more patients per nurse in Germany 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 from the current studies are not surprising," said the managing director of the German Professional Association for Nursing Professions (DbfK), Franz Wagner, according to press reports. "We believe that there is a comparable trend in Germany as well." Today, demographic developments would place very different demands on hospital staff. The many chronically ill patients would need more intensive care and advice on how to deal with their illness. Nurses are much more able to recognize complications or structural defects in care if they are 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 model level there are currently dual training courses in cooperation with some universities.

Chronic shortage of care in Germany The fact that not everything runs smoothly in German hospitals can now also be seen in the chronic lack of care, which was partly caused by the massive job cuts. This not only leads to an overload of the employees, but also obviously becomes an increasing risk for the patients. The problems are home-made, since 50,000 full-time positions have been cut in German hospitals since 1996, despite increasing workloads and continuously increasing patient numbers. (sb)

Image: Gerda Mahmens /

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