Staffing levels and patient dependence in English stroke units.
Little research has been performed to determine how a stroke unit should be staffed and what the links are between patient dependency and staffing. For this study, 140 stroke units were randomly selected--35 from each of the four quartiles of performance in the National Sentinel Audit of Stroke. A questionnaire was sent to each of the units to collect data on patient numbers and dependency, staffing numbers and therapy, and nursing contact times on a single weekday. The response rate was 66% (92 sites) and information on 1,398 patients was provided. The median number of beds was 18 (interquartile range 12-24). Staffing levels per 10 beds were a median of 10.9 nurses, 1.7 physiotherapists, 1.3 occupational therapists and 0.4 speech and language therapists. Of the patients, 74% received physiotherapy, 46% occupational therapy and 25% speech and language therapy during the day with median contact times being 170 minutes for nursing, 40 minutes for physiotherapy, 45 minutes for occupational therapy and 30 minutes for speech therapy. There was a weak correlation between patient dependency and contact time with nurses and therapists. Stroke patients in England receive relatively little rehabilitation from therapists and there is a wide variation in the amount of nursing time each patient receives.
Clinical Standards Department, Royal College of Physicians, London. anthony.rudd@kcl.ac.uk
Anthony G
AG
Rudd
Damian
D
Jenkinson
Robert L
RL
Grant
Alex
A
Hoffman
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004739:England; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009741:Nursing Staff, Hospital; D009788:Occupational Therapy; D005791:Patient Care / Q000706:statistics & numerical data*; D010561:Personnel Staffing and Scheduling / Q000592:standards; D010564:Personnel, Hospital / Q000600:supply & distribution*; D026761:Physical Therapy Specialty; D011787:Quality of Health Care / Q000592:standards*; D013070:Speech Therapy; D020521:Stroke / Q000451:nursing / Q000628:therapy*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013997:Time Factors; D000078329:Workforce