Queensland nurse ratio legislation ‘saving lives and money’

Mandated minimum nurse staffing standards have been in place for selected acute surgical and medical hospital wards, and mental health units in Queensland since July 2016.

“The rigorous evaluation shows that the policy was justified and is saving lives and money”

Matthew McHugh and Linda Aiken

The ratios are one nurse to four patients for morning and afternoon shifts and one nurse to seven patients for night shifts.

Queensland Health – the government department in charge of the state’s public health system – commissioned the University of Pennsylvania to carry out an independent evaluation of the new ratio system.

The findings, presented earlier this month and due to be handed over to the Queensland state government in August, show in the first year of implementation, the ratios have saved 145 patient lives.

They have also avoided 255 readmissions and 29,200 hospital days, with an estimated cost saving of between $55.2m to $83.4m (£30.7m to £46.5m).

In addition, the average nurse on wards included has seen their workload reduce by one to two patients during the day, and one to three on a night shift.

Reductions of one patient per nurse were associated with a 9% less chance of a patient dying in hospital, a 6% less chance of readmission within seven days, and a 3% reduction in length of stay.

In addition, having one less patient on their caseload was associated with a 7% reduction in nurse burnout.

The results add to a growing body of evidence showing links between nurse staffing levels and patient safety.

This study goes a step further as it reveals the financial benefits of introducing nurse workforce standards.

In a joint statement, professors Matthew McHugh and Linda Aiken, the academics leading the evaluation, said the research would be helpful to other jurisdictions considering new laws around nurse staffing.

“The research will be helpful to many other jurisdictions”

Matthew McHugh and Linda Aiken

“Queensland Health is to be commended for its evidence-based policymaking that included the funding of a prospective independent evaluation of the outcomes of establishing minimum nurse-to-patient ratios in the state,” they said.

“The rigorous evaluation shows that the policy was justified and is saving lives and money.

“The research will be helpful to many other jurisdictions considering implementing safe nurse staffing legislation,” they added.

Queensland is understood to be the first jurisdiction in the world to apply a method of research that looked at both pre and post ratio rollout.

In this first stage of the implementation, the ratios have only applied to certain wards across 27 public hospitals.

On its website, Queensland Health said it will consider expanding the legislation based on the findings of the independent evaluation.

The department also said it recognised that there may be some health settings that require a higher nurse-to-patient ratio.