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By Prof Eustarkio Kazonga

This article focuses on the use of statistics in the nursing profession. According to the World Health Organisation (WHO), nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well in all settings.

It includes the promotion of health, the prevention of illness, and care of the ill. Some of the statistical skills necessary for a nurse are measurements, drawing and interpretation of charts and diagrams, handling and quantifying variation and uncertainty.

Human beings differ in response to exposure to risk factors for different diseases. Human beings also differ in disease symptoms and their response to different types of treatments. All nurses need to be able to summarise results and to interpret summaries and also be able to display health care data in various ways. Use of statistics is, therefore, necessary in the nursing profession.


Importance of statistical literacy 

“The world of the twenty-first century is a world awash in numbers” (Steen, 2005). Numbers are not only important because they are pervasive and they are pervasive because they are important. It is because numbers have both the power to influence and the power to inform that we need to educate citizens to attend to numbers, to understand them, and to think thoughtfully and critically about them (Lutsky, 2008). It is in this context that nurses require statistical knowledge and skills.


Nurses Need to Understand Statistics

Rickard (2008) states that in order to overcome some common misconceptions, there is need for statistical knowledge and skills. Statistics have been a fundamental part of the nursing profession skills since the days of Florence Nightingale who was the first known nurse statistician and the founder of the profession of nursing. During the Crimean War, Nightingale used statistics to show that improved sanitary conditions led to fewer military deaths. She focused on standardisation of collection of medical data and encouraged benchmarking, even when statistics showed her hospital had the worst mortality rate. Today’s nurses also need a working knowledge of nursing statistics for the profession to evolve and improve. The amount of clinical research published each year continues to grow, along with the expectation that nurses will incorporate evidence-based practices in hospitals, clinics, nursing homes, physicians’ offices, and other settings.


Enhance Patient Care

Statistics allow nurses to prioritise treatment and determine whether or not a patient requires follow-up care or immediate medical attention. Nurses can use statistics to identify patterns in vital signs and symptoms so they can make informed decisions to better respond to a patient’s changing medical status. Even the use data sheets or frequency charts to document the timing of medications given to patients is a way nurses use statistics.


Statistics help nurses to understand their patients

For example, data collected by critical care nurses in five third level hospitals showed that almost one third (32%) of patients had hallucinations, and that long after they leave hospital, many have no factual memory but strong emotional memories of the Intensive Care Unit (ICU). These types of statistics raise issues that may not be appreciated, and quantify their frequency and importance. They force nurses to confront realities, and they challenge them to respond. As need of health care services continues to grow, nurses can expect more patients and their loved ones to be aware of the statistics surrounding critical care, and to expect nurses to be able to discuss this with them in an informed manner (Rickard et al, 2005; Roberts et al, 2007).


Support Evidence-Based Practices

Nursing practice is increasingly based on empirical evidence that demonstrates the most effective protocols for patient care. Yet for evidence-based practice to become well established, clinicians must have a basic understanding of statistics to be able to read, understand, and interpret the relevant literature. Armed with statistics, clinicians can determine if commonly used methods or protocols should be revised based on the relevant research.


Statistics Help Nurses To Develop Their Profession

Advancing nursing as a profession requires statistics to develop and inform best practice. It is our responsibility to the public, who we serve, to constantly update and improve the body of critical care nursing knowledge. If we don’t move forward we will slip backward. There is nothing new about combining caring and statistics. Florence Nightingale, the founder of professional nursing, was committed to statistics and used them effectively to improve practice and lobby for changes to government policy. Through numbers, she showed that improved sanitary conditions led to reduced deaths, and encouraged the use of benchmarking, even when this showed her own hospital to have the worst mortality (Claire, 2008).

Statistics can be useful when it comes to allocating limited resources or bringing about change in the nursing profession based on facts, rather than relying on emotional pleas or subjective evidence.


Educate Trainee Nurses

Understanding statistics is an important requirement for preparing future nurses. Every trainee nurse whether pursuing a diploma, bachelors or an advanced degree programme in nursing has the ability to achieve a working knowledge of use of statistics. Nursing students at training institutions that embrace statistics are expected to improve their skills and confidence to deliver the highest level of care to their patients. Critical care nurses do not need to be statisticians, but they do need to develop a working knowledge of statistics. For those undertaking a research project, statistical literacy is required to interact with other researchers and statisticians, so as to best design and undertake the project (Rickard, 2008).

Statistics are able to grasp imagination and quantify perception. Statistics are harder to argue with than emotion or opinion alone. If you want to effect change, you are going to need statistics to back up your argument (Alken et al, 2009). If one says: “More nurses, less deaths”, it is much harder to argue with than general complaints about overwork and understaffing.


Statistics Help Nurses To Compare Options For Practice

How else do nurses really know whether nursing interventions are effective? Which dressing should we use? How often should we change it? Should nurses wear sterile, clean or no gloves during the procedure? Statistics can tell nurses that neither replacing intravenous administration sets, nor fluids, prior to a week are likely to reduce infection (Rickard et al, 2004). Statistics are important for decision making in critical care nursing. There are few settings where nurses have to make so many decisions each day as in intensive care units. Emotional instinct and experience alone are unreliable, but statistics can guide their decisions, and help them to make the right ones.


Statistics Teach Nurses To Be Cautious

Statistics can rarely ’prove’ anything but remind us that human life and experiences are complex. Finding out whether ’X causes Y’ may take many years and several studies, some with conflicting results, and it is important to be able to see the bigger picture, and the answer evolving, rather than leaping on the bandwagon of any one particular finding. This is an important counterpoint to busy critical care environments where confident and definitive answers may be the expectation. Modern statistics packages are a mixed blessing. Any amateur statistician can churn out hundreds of statistics in seconds, with a good chance of finding significant results due to incorrect tests or the large volume of tests performed. Alternately, even a technically perfect statistical analysis will not make up for problems in how the data were collected. When reading study results, always ask questions, question assumptions and be slow to draw conclusions (Rickard, 2008).

Accepting the importance of statistics; overcoming any fear of numbers and investing a small amount of effort are all that is required. Once you have grasped a concept will ensure you keep that knowledge. Like anything else, it takes practice and the more you do it the easier it gets. Critical care nurses can calculate drug doses, interpret numerous physiological parameters, and coordinate complex care.


Association Versus Causation

To be statistically literate, a nurse must be able to distinguish statements of association from statements of causation. It is often terms designating an association (e.g., factor, influence, related, followed, risk, link, etc.) are treated as asserting causation. To be statistically literate, one must know whether a statement of comparison involves association or causation. To put this into context, this can be illustrated by considering three claims about the results of an observational study: (a) People who are overweight tend to be hypertensive (b) Weight is positively associated with height (c) If you gain weight, you can expect to be hypertensive. The first statement is obviously an association. The second statement is often misinterpreted as asserting causation. The change in weight is mistakenly viewed as a physical change within a given subject. In fact, the change is a mental change: a shift in mental focus from below-average weight people to above-average weight people. The third statement obviously involves causality (Ibid).



In this article it has been demonstrated that statistics can be used to effectively improve nursing practice. It has to be noted that statistics are a way of viewing and understanding data that provides information and insight as to how one event relates to another. In the nursing profession, the use of statistics directly affects patient care and advocacy efforts to advance the profession. Nurses need to have the ability to use statistics as evidence in healthcare arguments. Nursing practice involves use of statistics. There is no need to fear use of statistics in the nursing training programme or in the actual practice of nursing.


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