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Setting nurse-patient ratios saves lives and prevents burnout, ICN told

Researchers point to success of introducing strict nurse-patient ratios in US and Australia

Researchers point to success of introducing strict nurse-patient ratios in US and Australia


Picture: John Houlihan

Setting nurse-patient ratios not only saves lives but can prevent burnout and help with staff retention, the International Council of Nurses (ICN) congress heard.

The event in Singapore was told how introducing such ratios in the Australian state of Queensland and in California in the US had helped to reduce readmissions and mortality rates, save money and increase nurses’ job satisfaction.

The evidence was presented by nurse researchers Linda Aiken and Matthew McHugh, director and associate director respectively of the Center for Health Outcomes at the University of Pennsylvania School of Nursing.

Gold standard

Professor McHugh said Queensland, which introduced safe staffing ratios in 2016, had set the ‘gold standard’.

Data showed that introducing a maximum nurse-patient ratio of 1:4 on a day shift and 1:7 on a night shift had improved outcomes. Since the ratios were introduced a total of 145 patient deaths, 255 readmissions and 29,000 extra hospital days had been avoided, amounting to a saving of US $20 million (£15.9 million).

No nurse in California is now legally allowed to care for more than five adults at any one time. The move had prompted some nurses to come out of retirement, because they enjoyed being at work again, the conference heard.

Going backwards

Professor Aiken said there was enough published evidence to show that improved nurse-patient ratios meant better outcomes for patients and for nurses in terms of improved job satisfaction. She said it was time to start implementing interventions.

‘To paraphrase Florence Nightingale, if we wait for a year, a month or even a week we are going backwards,’ she said.

‘We should turn our attention to test interventions that can fix this problem of a shortage of nursing care at the bedside.’

Wales implemented a nurse staffing law in April 2018 for adult acute medical and surgical inpatient wards, and in May this year Scotland’s safe staffing law was passed, covering all clinical groups in health and social care services. However, neither Scotland nor Wales have adopted a set nurse-patient ratio.

The RCN is campaigning for UK-wide safe staffing legislation.


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