Increasing nurse staffing levels in cardiac surgery centres appears to be a cost effective patient safety intervention.

Over the past decade there has been worldwide interest in the effect of nurse staffi ng on quantifi able patient outcomes. In numerous multi-centre studies of hospitalised adults, in-hospital mortality has been reported to be inversely associated with nurse staffi ng levels.1–3 There are fewer published data establishing the trade-offs and associations between resources provided and quality of care. Policy makers interested in the cost, quality and effectiveness of healthcare will fi nd guidance in this article. Van den Heede and colleagues reported on their costeffectiveness analysis from a hospital perspective of increased nurse staffi ng levels to the 75th percentile in Belgian general cardiac postoperative nursing units in the year 2003. They compared the costs of increased nurse staffi ng levels with the benefi ts of reducing mortalities. A two model approach included the simulation of an increase in the number of nursing hours per patient day to the 75th percentile for nursing units below that level. A ‘do nothing’ alternative model was used for the comparator group. Cost data from the year 2007 were extracted and the results were expressed in the form of the ‘additional costs per avoided death’ and the ‘additional costs per lifeyear gained’. In this study, increasing nurse staffi ng levels appears to be a cost-effective strategy in comparison to other cardiovascular interventions.