Report: California Nurse Ratio Standards Decrease Mortality, Increase Nurses Job Satisfaction

A recent study published online in the journal Health Services Research has indicated that hospitals that meet the standards set forth by the State of California in mandating nurse/patient ratios have decreased mortality rates and burnout rates among nurses and increased levels of job satisfaction amongst nurses.  The study (link here), lead by Linda Aiken of the University of Pennsylvania School of Nursing, was funded by the Robert Woods Johnson Foundation, AMN Healthcare, Inc., the National Institute for Nursing Research and the National Institutes of Health.  The major findings of the study are after the jump:

Outcomes are better for nurses and patients in hospitals that meet a
benchmark based on California nurse staffing mandates whether the hospitals
are located in California. The higher the proportion of nurses in hospitals
whose patient assignment is in compliance with the benchmark set on California-
mandated ratios, the lower the nurse burnout and job dissatisfaction,
the less likely nurses are to report the quality of their work environment as only
fair or poor, the less likely nurses are to report that their workload causes them
to miss changes in patients’ conditions, and the less likely nurses are to intend
to leave their jobs. Similarly, the higher the percentage compliance with
benchmark based on California ratios, regardless of the hospital state location,
the less likely nurses are to report complaints from patients or families, verbal
abuse of nurses by staff or patients, quality of care that is poor or only fair, and
lack of confidence that their patients can manage after discharge.

There have been other earlier studies that have contradicted these findings, but I find this study compelling because it correlated the improved outcomes to the staffing ratios – location factors were not significant – i.e. that a hospital in Pennsylvania that adopted the California ratios had better outcomes that Pennsylvania hospitals that did not adopt the California ratios makes this study  more valuable than the earlier studies that looked  at care during different time intervals (before and after studies in california, for example).


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