Implications of the California Nurse Staffing Mandate for Other States

Health Services Research - Tập 45 Số 4 - Trang 904-921 - 2010
Linda H. Aiken1, Douglas M. Sloane2, Jeannie P. Cimiotti3, Sean P. Clarke4, Linda Flynn5, Jean Ann Seago6, Joanne Spetz7, Herbert L. Smith8
1Center for Health Outcomes and Policy Research, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104‐4217
2Center for Health Outcomes and Policy Research; University of Pennsylvania School of Nursing; Philadelphia PA
3Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA
4Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, University Health Network, Toronto, ON, Canada
5School of Nursing, University of Maryland, Baltimore, MD
6School of Nursing, University of California, San Francisco, 2 Koret Way, San Francisco, CA
7School of Nursing, University of California, San Francisco, UCSF Laurel Heights, CA
8Department of Sociology, Population Studies Center, Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA.

Tóm tắt

Objectives. To determine whether nurse staffing in California hospitals, where state‐mandated minimum nurse‐to‐patient ratios are in effect, differs from two states without legislation and whether those differences are associated with nurse and patient outcomes.Data Sources. Primary survey data from 22,336 hospital staff nurses in California, Pennsylvania, and New Jersey in 2006 and state hospital discharge databases.Study Design. Nurse workloads are compared across the three states and we examine how nurse and patient outcomes, including patient mortality and failure‐to‐rescue, are affected by the differences in nurse workloads across the hospitals in these states.Principal Findings. California hospital nurses cared for one less patient on average than nurses in the other states and two fewer patients on medical and surgical units. Lower ratios are associated with significantly lower mortality. When nurses' workloads were in line with California‐mandated ratios in all three states, nurses' burnout and job dissatisfaction were lower, and nurses reported consistently better quality of care.Conclusions. Hospital nurse staffing ratios mandated in California are associated with lower mortality and nurse outcomes predictive of better nurse retention in California and in other states where they occur.

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Health Services Research

Tập 45 Số 4

904-921

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