Nurse staffing ratios save lives

A new study by prominent nurse researcher Linda Aiken, RN, PhD, has linked minimum nurse-to-patient ratios to lower rates of patient mortality and increased nurse morale.

The study, which was published in Health Sciences Research, compared work conditions and outcomes in California, Pennsylvania and New Jersey. California enacted minimum nurse/patient ratios two years ago; Pennsylvania and New Jersey do not have legally mandated staffing ratios.

Aiken found that California nurses have more time at the bedside and are less likely to miss changes in patient condition. California nurses are also less likely to experience burnout. Patients of California nurses fare better as well.  According to the data, New Jersey and Pennsylvania hospitals would have 14 and 11 percent fewer deaths, respectively, if they matched California’s 1:5 staffing ratio in surgical units.

The California Nurses Association welcomed the study as proof that minimum nurse/patient ratios improve care. “This research documents what California RNs have long known — safe staffing saves lives,” said Malinda Markowitz, RN, co-president of the California Nurses Association/National Nurses United.

But the California Hospital Association minimized the positive impact of nurse/patient ratios. “California hospitals have been engaged in a host of quality of care initiative for the past several years…To assert that mandatory staffing ratios are the reason for improved patient outcomes…draws a false conclusion,” said Jan Emerson, vice president of external affairs for the California Hospital Association.

What do you think? Do minimum ratios improve patient care?

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Jennifer Fink, RN, BSN

Jennifer is a professional freelance writer with over eight years experience as a hospital nurse. She has clinical experience in adult health, including med-surg, geriatrics and transplant; she also has a particular interest in women’s health and cancer care. Jennifer has written a variety of health and parenting articles for national publications.

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5 Responses to Nurse staffing ratios save lives

  1. Valerie Muronda

    I believe that staffing ratios have to improve patient care. You cannot provide optimal care when you have too many patients. Hospital administrators want to rely on acuity based systems, however, nurses at the bedside know that our patients are sicker than ever before. Using acuity based systems just allows for administrators to say oh well your patients are not that sick, and such systems will make them less accountable for poor patient outcomes. Since nurses are often scapegoats for administrative problems such as staffing shortages, poorly run hospital pharmacies, patient dissatistaction with other nonnursing services, we should have the staffing and the resources to do our jobs to the best of our ability. Denying the need for staffing ratios and continuing to blame nurses when things go wrong cannot continue. It sure will not get our patients any better.

  2. Doreen

    I definetly feel there should be a set ratio 1:5 seems good, 6 and 7 patients is just too much. All you have time for is to pass meds and chart, I personally feel it is bad nursing to have more than 5 patients, what happened to actual patient care. The acuity of the patients also make a difference. If you have 6 patients that are all needing your time how can you not miss something or feel pressured, its just impossible. I think all states should limit the ratio for safe and effective nursing.

  3. shenetha

    i work in long term care and i have 22 pts. i REALY feel like that is to many people to have to give care to. yeah i miss things sometimes but how can i not? i am so overwhemled at times and i know all of my pts. are not getting the care they deserve. i feel like all i do some days is pass meds and chart. a-lot of things in nursing need to change.

  4. melissa

    I agree. A safe nurse: patient ratio is necessary. Administration says they look at acuity but they are looking at the admitting diagnosis and not all of the comorbities that go along with the sicker patients that are hospitalized now. I am a float med/surg nurse and have been in the profession for 20 years now in various positions including home care. I see changes with this new company “for profit” not caring about patient safety or mortality for they feel that labor costs are what is bringing down the hospital and not all of the free care that we give. We haven’t had a raise in the 6 years I have been there and new nurses that are hired make more than I. Others are leaving fast for they cannot safely take care of patients like we used to and catch the small signs that can mean a drastic change either way for a patient for the “nurse” is who used to see the patient the most and observe those little signs that we would notify the MD about BEFORE the patient deteriorated too quickly. Safety is a priority and should always remain a priority.

  5. Viola Wake

    My comment here is why does hospitals go with the minimum allowed staffing instead of the appropriate amount of staffing whether it be of nurses (RN or LVN as well as CNA’s) It seems to me that they would want the maximum so the can be on top of everything which seems much easier for patients as well as employees