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Law has boosted US nurse staffing ratios in hospitals and care homes

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A law requiring hospitals and nursing homes to publicly report the number of patients per nurse has led to better staffing ratios, a US study has found.

Since the law was introduced in the state of New Jersey in 2008 the nurse to patient ratio increased in 10 out of 13 specialities, according to research in the journal Policy, Politics and Nursing Practice.

“Nurses can also become more knowledgeable about existing staffing policies”

Pamela de Cordova

The research, carried out by Rutgers School of Nursing in New Jersey, is the first to assess the impact of the law, which requires hospitals to publish detailed information about nurse staffing levels.

“Nurse staffing, particularly for registered nurses, has been shown to have a direct impact on patient outcomes, such as rates of infection, falls, heart attacks and even death. Insufficient nurse staffing also can affect a patient’s length of stay in the hospital,” said lead researcher Pamela de Cordova, an assistant professor at the nursing school.

“By reporting and analysing the data and ensuring that nurses are included in staffing discussions, patient outcomes can be improved.”

The legislation requires hospitals to display information about staffing where patients can see it, including staff/patient ratios for different types of staff such as nurses and nursing assistants.

Hospitals also must submit the information each month to the New Jersey Department of Health, which posts the information online.

New Jersey is one of only five states to require hospitals and nursing homes to report nurse staffing numbers.

However, Ms de Cordova said it was likely many patients were unaware of this or unable to interpret the staffing data and said there was a need to improve the way data was collected and ensure people knew about it.

“Publicly available, scientifically validated information can help patients become more informed and empowered when making decisions about their health care and where to obtain it,” she said.

Meanwhile there was also a need to raise awareness among nurses who could the information to make decisions about where to work or lobby managers for changes to staffing levels.

“For nurses in New Jersey, being cognisant of this law can also empower them to choose to work in hospitals with the best staffing,” she said.

“Nurses can also become more knowledgeable about existing staffing policies and use that information to advocate for better quality of care for patients,” she added.

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Readers' comments (1)

  • Establishment Genie can capture staffing data across all health and care settings, and provide individual and benchmark reports. The work we have been conducting with Care Homes in Wales to capture data in support of the Nurse Staffing Act (Wales) 2016 provides all Homes with an instant individual report on staffing ratios including hours and minutes of care per resident by staff group; as well as residents per nurse / band 4 / HCSW, WTE per resident; and reports on any supporting staff, clinical supervision, training and uplift. The Homes are using this as evidence of deployment of appropriate and safe staffing with inspectors, commissioners and other funders, and with residents and their families, and the peer benchmark (variation) group anonymously compares all of the homes on up to 500 different metrics including outcome measures and is tangibly improving quality. It is not just America that is putting the person at the centre of care and empowering nurses and carers!

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