(HealthDay News) — The risk for patient death associated with low nurse staffing is only partly alleviated by using temporary staff to fill shortfalls, according to a study published online Aug. 19 in JAMA Network Open.

Peter Griffiths, RN, PhD, from the University of Southampton in the United Kingdom, and colleagues explored the association between composition of the nursing team and risk for patient deaths. The analysis included data from 185 wards in four acute hospital trusts in England between April 2015 and March 2020 covering 626,313 admissions.

The researchers found that the risk for death was higher when patients were exposed to low staffing from registered nurses (RNs; adjusted hazard ratio [aHR], 1.08) and nursing support staff (aHR, 1.07). For each 10% increase in the proportion of temporary RNs, there was an increase in the risk for death, with no difference between agency (aHR, 1.023) and bank staff (aHR, 1.02). Each 10% increase in the proportion of agency nursing support was associated with an increase in the risk for death (aHR, 1.04). Evidence on the seniority of staff was mixed.

“These findings indicate that while the benefits of avoiding low staffing may be greater than the harms associated with using temporary staff, particularly for RNs, risk remains elevated if temporary staff are used to fill staffing shortages, which challenges the assumption that temporary staff are a cost-effective long-term solution to maintaining patient safety,” the authors write.