• Researchers’ findings linked number of registered nurses working on a ward to number of instances of aggression and harassment suffered by staff
  • Study calls for “greater efforts” to improve staff safety, which could boost retention and patient safety

Increasing the number of registered nurses working in mental health settings could help protect thousands of other NHS staff, according to research shared with HSJ and published today.

Academics at Birmingham City University analysed three years’ worth of data from Mersey Care Foundation Trust and found a correlation between staff safety and nurse staffing levels and skill mix.

The analysis found when registered nurses exceeded the clinically required level – the number of staff required to ensure safety on a ward – on early and late shifts, there was a decrease in “adverse events” towards staff, such as aggression, harassment or sexual incidents.

The study also found when clinical demand was low, for example, during the night shift, there was a greater risk of “adverse events” being reported.

In total, researchers found more than 10,000 adverse events were recorded, with nearly 20,000 staff as victims. Five hundred staff members were victims of sexual incidents and there were more than 6,500 instances of patient aggression.

The study recommended “greater efforts” should be made to improve staff safety, which “might improve retention and simultaneously patient safety”.

It added clinical judgement was “clearly of use when determining staff levels” but it “needs to be complemented with operational considerations”.

RNs a ‘silver bullet’

“Increasing the use of RNs is a growing ‘silver bullet’ by which we can fix the pressures faced by the NHS, but increasing demand does not fix the issue of supply,” the report said.

It continued: “Little consideration is given to the safety of the staff delivering care. In a time where workforce retention is proving difficult and the quality and safety of care to patients is compromised, greater efforts should be made to improve staff safety.”

Sarahjane Jones, principal investigator and senior research fellow in health and social care at Birmingham City University, said: “These findings are the first to address staff safety using data in this way and offer an opportunity for policy on both safety culture and workforce safety and retention.”

Dr Jones continued: “While increasing nurse safety had a key role to play in improving staff retention rates amidst a nationwide nursing shortage, there was not one single solution to this complex problem.”

She added: “On a practical level, efforts to reduce violence and risk of harm to staff could lead to improvements in nurse retention. It’s about more than just increasing the numbers though, it’s about a comprehensive package of support.”

Alison Leary, co-author and professor of healthcare and workforce modelling at London South Bank University, said: “This research adds to a very limited body of knowledge on both staff safety and safety in mental health settings.”

“Safe environments are essential for good care and staff retention,” Professor Leary added.