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Mandated Nurse Staffing Ratios in California: A Comparison of Staffing and Nursing-Sensitive Outcomes Pre- and Postregulation
Linda Burnes Bolton, DrPH, RN, FAAN
Cedars-Sinai Health System/Burns & Allen Research Institute
Carolyn E. Aydin, PhD
Cedars-Sinai Medical Center/Burns & Allen Research Institute
Nancy Donaldson, RN, DNSc, FAAN
Center for Research and Innovation in Patient Care at the University of California, San Francisco School of Nursing
Diane Storer Brown, RN, PhD, FNAHQ
Quality & Continuous Readiness for Accreditation, Regulation and Licensing
Meenu Sandhu, MS
Cedars-Sinai Medical Center/Burns & Allen Research Institute
Moshe Fridman, PhD
AMF Consulting, Inc.
Harriet Udin Aronow, PhD
Cedars-Sinai Medical Center/Burns & Allen Research Institute
This article examines the impact of mandated nursing ratios in California on key measures of nursing quality among adults in acute care hospitals. This study is a follow-up and extension of our first analysis exploring nurse staffing and nursing-sensitive outcomes comparing 2002 pre-ratios regulation data to 2004 postratios regulation data. For the current study we used postregulation ratios data from 2004 and 2006 to assess trends in staffing and outcomes. Findings for nurse staffing affirmed the trends noted in 2005 and indicated that changes in nurse staffing were consistent with expected increases in the proportion of licensed staff per patient. This report includes an exploratory examination of the relationship between staffing and nursing-sensitive patient outcomes. However anticipated improvements in nursing-sensitive patient outcomes were not observed. This report contributes to the growing understanding of the impacts of regulatory staffing mandates on hospital operations and patient outcomes.
Key Words: nurse-to-patient ratios • nursing sensitive indicators • patient safety and quality • falls • pressure ulcers • outcomes
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Policy, Politics, & Nursing Practice, Vol. 8, No. 4,
238-250 (2007)
DOI: 10.1177/1527154407312737
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