Setting minimum staff to patient ratios could create a more stable nursing workforce that is less dependent on agency cover, while improving safety, according to the latest academic review.
The government has so far rejected calls to introduce minimum registered nurse to patient ratios, despite repeated calls from nursing unions.
The National Nursing Research Unit at King’s College London looked at international evidence from places where ratios have been introduced.
California set a ratio of 1:5 on medical and surgical wards in 1999. The review found no evidence the move had increased costs and said nurses typically cared for one less patient than in other US states.
Mandatory ratios were introduced in the Australian state of Victoria in 2001 and set at 1:4, plus one manager. Studies had shown the ratios had led to better recruitment and retention of nurses, more workplace stability and reduced stress, the review said.
The evidence suggested mandated ratios could “improve nurse staffing and lead to better recruitment, generate a more stable workforce, and more manageable workloads for staff”, the review stated.
“The impact on patient outcomes is less clear but there is evidence that the resultant lower caseloads are related to lower levels of patient mortality,” it added.
Ratios are “arguably simple and easy to use”, the review said, but it noted investment would be required to set up and monitor them. “Careful consideration” would need to be paid to variations in patient needs, especially between specialities, it added.
Unison called on nurses to record the number of patients per staff member on their wards earlier this month as part of a national survey.