New York State's hospital nurse staffing legislation predicted to save lives and money

According to a new study published in Medical Care, improving hospital nurse staffing as proposed in pending legislation in New York state would likely save lives. The cost of improving nurse staffing would be offset by savings achieved by reducing hospital readmissions and length of hospital stays.

Researchers at the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing, conducted independent research in early 2020 on whether pending nurse staffing legislation in New York state is in the public's interest. The study of 116 hospitals and 418,000 Medicare patients documented large differences in patient-to-nurse ratios by hospital from an average of 4.3 patients for each nurse to as many as 10.5 patients per nurse. The wide variation in patient-to-nurse ratios across hospitals in New York is contributing to avoidable deaths and unnecessary costs.

The new study finds hospital deaths and costs of care are significantly lower in hospitals with better nurse staffing. Each additional patient added to a nurse's workload is associated with 13% higher in-hospital mortality and 8% higher readmissions. Similarly, the odds of staying a day longer in the hospital, a major cost factor, increased by 9% for surgical patients and 5% for medical patients.

Lead author Karen Lasater, Ph.D., RN, an assistant professor and CHOPR researcher said, "Results show that improving nurse staffing in New York hospitals could substantially reduce deaths and save money that could go to funding improved staffing."

Researchers estimated that if all New York hospitals had staffed at levels recommended in pending state legislation of not more than 4 patients per nurse on medical and surgical units, over a two-year period more than 4,370 deaths could have been avoided and over $720 million saved just among Medicare patients alone and likely considerably more across all hospitalized patients.

Co-author, Linda H Aiken, Ph.D., RN, a senior researcher at CHOPR and professor at the University of Pennsylvania said, "This independent scientific study shows that setting a quality standard for nurse staffing in hospitals is in the public's interest. It is also feasible to fund because of significant savings associated with avoided days of care associated with better patient care."