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Setting Nurse-to-Patient Ratios = More RNs

Legislation in California that set nurse-to-patient ratios added more registered nurses to the hospital staffing mix, not fewer as feared, researchers say.

Lead researcher Matthew McHugh, a nursing professor at the University of Pennsylvania in Philadelphia, says California was the first state to pass legislation setting staffing levels. However, mindful of the ongoing nurse shortage California legislators determined that hospitals could employ licensed practical nurses as well as registered nurses to meet the requirements of the law, McHugh says.

“California’s state-mandated nurse staffing ratios have been shown to be successful in terms of increasing registered nurse staffing,” McHugh says in a statement. “From a policy perspective, this should be useful information to the states currently debating legislation on nurse-to-patient ratios.”

California experienced a more serious nurse shortage than other areas of the country but made up the gap by hiring “travel nurses” — temporary workers who move from hospital to hospital as needed and ae not less educated LPNs, the researchers say.

The study, published in the journal Health Affairs, examined hiring practices from 1997 to 2008, pre- and post-implementation of the legislation, concluding that the increase in nurse staffing did not come at the expense of decreasing RNs.

“Our findings demonstrate that the nurse-to-patient ratio mandate in California was effective in increasing registered nurse staffing in hospitals,” McHugh says.

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