Nurse-to-Patient Ratios

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Coffman, J. M., Seago, J. A., & Spetz, J. (2002). Minimum nurse-to-patient ratios in acute care hospitals in California. Health Affairs, 21(5), 53-64. Retrieved from

In the article, Coffman, Seago, and Spetz (2002) questioned that mandating minimum nurse-to-patient ratios could eventually help to improve outcomes and conditions of both nurses and patients in acute care hospitals in California. They found that mandatory ratios could create opportunity costs that were not easily measured and that might outweigh their benefits. They also suggested that policymakers should consider other strategies or approaches to address nurse’ concerns on hospital staffing and enhance their job satisfaction and retention in hospital facilities. The authors showed that proponents of Assembly Bill 394 emphasized its potential to improve the quality of care provided to patients and reduce the turnover in nursing staff in California hospitals, but it also created more problems in hospitals. The potential benefits of Assembly Bill included helping to alleviate the nursing shortage, improve working conditions, and attract more young persons to nursing. In the meantime, the authors also reported that many California hospitals and their units were not in compliance with proposed minimum nurse-to-patient ratios. The minimum nurse-to-patient ratios increased hospital expenditures. Hiring registry and traveling nurses and increasing LVN staffing would increase hospital expenditures and lower quality of patients’ care. Because of mandatory ratios, hospitals were most likely to reduce other personal and increase the amount of nonnursing work performed by Registered Nurses. Mandating minimum nurse-to-patient ratios also discouraged innovation in the development of other types of health professionals by hospitals and in the amounts and combinations of labor and capital. The authors...
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