Patient safety: minimum staff to patient ratios cut death rates

The US state of California introduced a minimum ratio of five patients per nurse on medical and surgical wards in 2005.

Researchers compared staffing and outcome data from California with two other states – New Jersey and Pennsylvania – that have no set nurse to patient ratios. The two year study looked at patient mortality within 30 days of surgery and survey data on staffing levels from 22,236 nurses. They concluded at least 10 per cent fewer patients would have died in New Jersey and Pennsylvania if they had minimum ratios. 

Lead author Linda Aiken, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania school of nursing, said nurses were the first to detect the majority of complications and medication errors in patients.

“Nurses are the main surveillance system in hospitals,” she said in the journal Health Services Research.

The US study follows research by Dr Foster Intelligence which showed that the more nurses a trust employed per bed the fewer of its patients were likely to die or experience long stays.

A 2006 piece of research, carried out by the Florence Nightingale School of Nursing and Midwifery at King’s College London, found surgical ward mortality was 26 per cent higher in trusts with the lowest nurse patient ratios compared to those with the highest.