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Outcomes Improved With Minimum Nurse-to-Patient Ratio

MONDAY, May 17, 2021 -- Implementation of a minimum nurse-to-patient ratio in Queensland improved nurse staffing and patient outcomes, according to a study published online May 11 in The Lancet.

Matthew D. McHugh, Ph.D., from the University of Pennsylvania in Philadelphia, and colleagues conducted a prospective panel study comparing Queensland hospitals subject to the ratio policy and those that were not subjected to ratios before and two years after implementation. A total of 231,902 patients were assessed at baseline (2016), and 257,253 were assessed in the postimplementation period (2018).

The researchers found that in comparison hospitals, the mortality rates were not significantly higher after implementation, while in intervention hospitals, they were significantly lower than at baseline (adjusted odds ratio, 0.89). Readmissions increased in comparison hospitals from baseline to postimplementation, but not in intervention hospitals. Postimplementation, length of stay decreased in both hospitals, but intervention hospitals had a more pronounced reduction (adjusted incident rate ratio, 0.95). From baseline to postimplementation, staffing changed in hospitals; 83 percent of the hospitals with reliable staffing measures had more than 4.5 patients per nurse at baseline compared with 58 percent of hospitals postimplementation. Most of the change was at intervention hospitals. A staffing improvement of one patient per nurse resulted in reductions in mortality, readmissions, and length of stay. The costs avoided due to fewer admissions and shorter length of stay exceeded those of additional nurse staffing.

"Having enough nurses with manageable workloads has been shown to be important for good patient care and outcomes," the authors write.

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