Assigning fewer surgical patients per nurse saves lives, improves the quality of care and prevents staff burnout, according to an analysis of a 2004 California law requiring mandatory nurse-patient ratios in acute care hospitals.
Researchers at the University of Pennsylvania found that if Pennsylvania and New Jersey had laws similar to California's, which requires a minimum of 1 nurse for every 5 surgical patients, 10.6% and 13.9% fewer surgical patients would have died in those states, respectively, between 2005 and 2006.
California is the only state to enforce minimum nurse-to-patient ratios; 18 other states are currently considering similar laws. To assess the impact of California's mandate, researchers led by Linda Aiken, RN, PhD, director of UPenn's Center for Health Outcomes and Policy Research, compared reports of patient deaths within 30 days of surgery and surveys of 22,236 hospital staff nurses in the 3 states.
On average, California surgical nurses cared for about 2 fewer patients than New Jersey and Pennsylvania nurses in 2005 and 2006, according to the findings published in the journal Health Services Research. California nurses also reported higher job satisfaction rates and lower levels of burnout than their East Coast counterparts.
Overall, Ms. Aiken's research found that 468 patient lives would have been saved in New Jersey and Pennsylvania over the 2-year period had those states mandated lower nurse-patient ratios.
"Nurses are the main surveillance system in hospitals," explains Ms. Aiken. "Nurses detect the majority of complications; the majority of medication errors that are detected by anyone are detected by nurses first." She concludes that "the California experience may inform other states that are currently debating nurse ratio legislation."
Irene Tsikitas
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