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The University of Southampton
Health Sciences

Study to investigate nurse staffing levels and safe care

Published: 30 July 2015

A University of Southampton study will investigate how the provision of nurses in hospitals affects the care and safety of patients.

Funded by the National Institute for Health Research: Health Services and Delivery Research (HS&DR) Programme and working with Portsmouth Hospitals NHS Trust and the universities of Portsmouth and York, the research will examine the relationship between nurse staffing levels, failure to observe patients’ vital signs and possible consequences – such as cardiac arrest calls, unanticipated admission to intensive care and death. Missed opportunities to observe and act upon the deterioration of a patient’s condition are thought to be important factors in preventable hospital deaths.

Professor Peter Griffiths of Health Sciences at the University of Southampton will lead the research and comments: “The potential for inadequate nursing care to do patients great harm has emerged as a factor in several recent reports into failings in NHS hospitals. These have often noted that staffing levels were an important issue associated with poor care and deaths which could have been avoided.

“Our study will help give a clear picture of the relationship between staff numbers and negative patient outcomes, using data routinely collected on hospital wards, during thousands of nursing shifts.”

Deputy project lead is Dr Jim Briggs, director of the University of Portsmouth’s Centre for Healthcare Modellling and Informatics, who brings expertise on clinical outcome modelling.

In partnership with the Clinical Outcomes Research Group at Portsmouth Hospitals NHS Trust (PHT), the researchers will gather anonymised information from 32 general inpatient wards across 100,000 shifts. It will use data on nurse staffing levels, combined with vital signs observations and information on the outcome of patients’ treatments.

Debra Elliott, Deputy Director of Nursing at PHT, says: “Patient care and patient safety are at the heart of everything we do, and we are delighted to be working with the University of Southampton on this very valuable research.

“Our participation will enable us to look in unprecedented detail at how staffing levels can impact on patients, and this will be an invaluable learning experience.”

Previous studies have relied on nurses to report the care they missed. This research aims to be more accurate by using data directly from ward records. Data will be derived from a number of sources including nurses’ handheld devices, a cardiac arrest database, intensive care unit admissions and laboratory records.

The study will conclude by estimating the staffing required on different types of hospital wards to ensure the observation of vital signs by nurses remains at an acceptable level. It will assess the costs and consequences of different staffing policies and give guidance on the importance and costs of different mixes of nursing skills to achieve consistent observation of patients and ultimately their safe care.

The authors aim to publish their findings in December 2017.

Related Staff Member

Notes for editors

For more information about the study, Nurse staffing levels, missed vital signs observations and mortality in hospital wards: modelling the consequences and costs of variations in nurse staffing and skill mix. Retrospective observational study using routinely collected data, please visit:

The National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme was established to fund a broad range of research. It builds on the strengths and contributions of two NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which merged in January 2012. The programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services, including costs and outcomes. The programme will enhance the strategic focus on research that matters to the NHS. The HS&DR Programme is funded by the NIHR with specific contributions from the CSO in Scotland, NISCHR in Wales and the HSC R&D Division, Public Health Agency in Northern Ireland.

The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website ( This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

Portsmouth Hospitals NHS Trust (PHT) has five registered locations: The Queen Alexandra Hospital, Gosport War Memorial Hospital, St Mary’s Community Campus, Fareham Community Hospital, Petersfield Community Hospital, St and eight Renal Dialysis Units across Hampshire and the Isle of Wight. The majority of the Trust's acute services are now provided at Queen Alexandra Hospital following the completion of recent redevelopment.

Queen Alexandra Hospital has around 1,255 beds.

Gosport War Memorial Hospital - Ark Royal Ward (22 beds) and Blake Maternity Unit (6 beds)

Petersfield Community Hospital (Cedar Ward) (15 beds).

The local population is around 675,000.

The number of staff is around 7,000.

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