California’s nurse-to-patient staffing law reduces patient deaths, allows nurses to spend more time with each patient and helps keep experienced nurses on the job, a new study by University of Pennsylvania researchers documents.
The study shows that if other states followed the California ratios, patients’ lives also would be saved, too. Says Malinda Markowitz, RN, and co-president of the California Nurses Association/National Nurses United (CNA/NNU), the study shows what “California RNs have long known—safe staffing saves lives.”
We see the effects every day at the bedside in improved patient care, an enhanced quality of life for patients and nurses able to more safely practice the profession to which we have dedicated our lives.
The California staffing law was implemented in 2004 following a long fight led by the CNA/NNU. The first-in-the-nation law established a minimum nurse-to-patient ratio of one to five. Before the law was implemented it was not uncommon to find a single nurse in charge of eight, 10, 12 or more patients on a shift.
The study, “Implications of the California Nurse Staffing Mandates for Other States,” was published in the policy journal, Health Services Research. It was conducted by University of Pennsylvania researchers led by Linda Aiken, RN, Ph.D., director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.
The study surveyed more than 22,000 RNs in California, New Jersey and Pennsylvania and its findings include:
- New Jersey hospitals would have 14 percent fewer patient deaths and Pennsylvania 11 percent fewer deaths if they matched California’s 1:5 ratios in surgical units.
- California RNs have far more time to spend with patients and more of their hospitals have enough RNs on staff to provide quality patient care.
- Fewer California RNs miss changes in patient conditions because of their workload than New Jersey or Pennsylvania RNs.
- In California hospitals with better compliance with the ratios, RNs cite fewer complaints from patients and families and the nurses have more confidence that patients can manage their own care after discharge.
- California RNs are far more likely to stay at the bedside, and less likely to report burnout than nurses in New Jersey or Pennsylvania.
Aiken, the report’s main author, says if New Jersey and Pennsylvania hospitals had been operating under the California ratio law, 468 lives
might have been saved over the two-year period just among general surgery patients….Because all hospitalized patients are likely to benefit from improved nurse staffing, not just general surgery patients, the potential number of lives that could be saved by improving nurse staffing in hospitals nationally is likely to be many thousands a year.
Markowitz says nurses in several states and in Congress are fighting to win safe staffing ratio legislation. In the U.S. Senate, S. 1031, the National Nursing Shortage Reform and Patient Advocacy Act, is modeled after the successful California law.