Stroke Mortality and Weekend Working (BBC News / PLoS Medicine)

Summary

A recent study indicates that stroke survival is associated with the number of nurses available at weekends, but not the frequency of doctors’ ward rounds. The importance of the so-called “weekend effect” is widely recognised across many areas of medicine, particularly with regard the importance of 24/7 consultant input in reducing weekend mortality rates; in contrast this study points to the relatively higher importance of nurse staffing levels for stroke care.

The researchers speculate that one of the main the reasons behind the particular importance of the nurse to patients ratio for mortality in stroke units at weekends may be the significant impact of better attention to patient hydration and nutrition upon post-stroke survival.

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Reference

Mundasad, S. (2014). ‘Nurse ratio’ at weekends key to stroke survival for patients. London: BBC Health News, August 19^th 2014.

This relates to:

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Reference

Bray, BD. Ayis, S. [and] Campbell, J. [et al] (2014). Associations between stroke mortality and weekend working by stroke specialist physicians and registered nurses: prospective multicentre cohort study. PLoS Medicine, August 19^th 2014, 11(8): e1001705.

A related commentary:

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Reference

Kerlin MP (2014) Staffing of healthcare workers and patient mortality: randomized trials needed. PLoS Medicine, August 19^th 2014, 11(8): e1001706.

Possibly also of interest, there is a US nursing website which provides wide-ranging evidence about the many different relationships between nurse staffing and patient safety.

2015 Update

A wide-ranging editorial literature review on the “weekend effect”:

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Reference

Lilford, RJ. [and] Chen, YF. (2015). The ubiquitous weekend effect: moving past proving it exists to clarifying what causes it. BMJ Quality & Safety. June 29^th 2015. [Epub ahead of print].

Incidental Side Issue: Alteplase for Treatment of Acute Ischaemic Stroke (BBC News)

The Medicines and Healthcare Products Regulatory Agency (MHRA) is setting up a review to look at the safety of alteplase, a thrombolytic (clot-busting) drug commonly used to treat strokes.

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Reference

Brimelow, A. (2014). Safety review into stroke clot-buster drug alteplase. London: BBC Health News, August 22^nd 2014.