An NSWNMA member survey highlights the link between understaffing and poor care outcomes.

Three quarters of nursing home falls could be avoided if minimum staff-to-resident ratios were in place, a new survey of aged care workers suggests.

Ninety-four per cent of NSWNMA members who took part in a survey said they had transferred a resident to hospital for treatment after a fall in the previous year.

Seventy-five per cent of the same aged care workers said those falls could have been avoided if minimum staff-to-resident ratios existed in their workplace.

A total of 1608 members working in aged care took up the Association’s invitation to complete a survey about their workplace earlier this year.

General Secretary of the NSWNMA, Brett Holmes, said the results show understaffing in aged care has reached “crisis levels” – especially given the loss of registered nurses.

“The federal government must mandate minimum staff-to-resident ratios across the aged care sector,” he said.

The survey showed:

• forty three per cent of members were employed in a facility with only one RN per shift to care for 50 to 100 residents
• eight per cent had only one RN per shift for 100 to 150 residents
• two per cent said they regularly had one RN for over 150 residents.

Brett said the figures highlight the urgent need for ratios that provide for appropriate levels of staffing and skills mix/qualifications.

“It would be an impossible task for RNs to maintain the required oversight and management of people prone to falling, given these unmanageable workloads,” he said

“Such situations would not be tolerated in a public hospital.”

The incidence of referrals to hospital for falls was slightly reduced for those workers employed on a ratio of one RN to zero–50 residents or patients, and further reduced where ratios of one–30 were usual.

This suggests the risk of falls is reduced as ratios of RNs to residents increase.

The 2018 annual report from the Australia and New Zealand Hip Fracture Registry shows over-representation from residential aged care facilities (RACFs) of people admitted to hospitals following a hip fracture.

The report also shows hip replacements originating from NSW RACFs put a significant cost on the public health system.

Of those hospitals providing data, Concord Hospital receives the highest number of hip fractures originating from RACFs in Australia, accounting for 45 per cent of all patients presenting with hip fracture there.

In 2016/17 there were a total of 106 stays at Concord Hospital for a hip replacement. Wollongong, St George Illawarra and Coffs Harbour are also among the top 10 Australian hospitals treating hip fractures originating in nursing homes.

Between 30–40 per cent of their patients admitted for a hip fracture lived in RACFs.

High cost of fractures

• More than 17,000 hip fractures occur in Australia each year, resulting in a $579 million financial burden, according to the Australian and New Zealand Hip Fracture Registry.
• At least 10 per cent of falls result in a fracture, with the incidence being higher among nursing home residents.
• A single uncomplicated hip replacement costs more than $20,000, according to the Independent Hospital Pricing Authority.
• Hip fractures in nursing homes likely cost more due to a high probability of pre-existing co-morbidities.
• Pressure injuries, diminished cognition and in extreme cases, death, are all complications of hip fractures.

Download the report: www.nswnma.asn.au/publications/reports