Standard Minimum Nurse-to-Patient Ratio Improves Outcomes

Queensland, Australia, began requiring certain hospitals to maintain a minimum nurse-to-patient ratio in 2016. In the current study (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00768-6/fulltext), researchers compared 30-day mortality, seven-day readmission, and overall length of stay rates for 231,902 medical-surgical patients at hospitals with (n = 142,986) and without (n = 88,916) the required minimum ratios. They also surveyed 17,010 medical-surgical nurses in the study hospitals before and after policy implementation.

Mortality rates were 18% lower and readmissions 6% lower in the hospitals with minimum staffing ratios. Both hospitals with and without the minimum ratios reported decreased length of stay, but it was lower in those that followed the ratios. The hospitals had averaged 4.5 patients per nurse, and reducing that number to 3.5 resulted in the best outcomes.

“In addition to producing better outcomes, the costs avoided due to fewer readmissions and shorter length of stay were more than twice the cost of the additional nurse staffing. Minimum nurse-to-patient ratio policies are a feasible approach to improve nurse staffing and patient outcomes with good return on investment,” the authors concluded (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00768-6/fulltext).