Concerned that inadequate nurse staffing may lead to patient harm, Massachusetts lawmakers signed a mandate into law in 2014 stipulating a 1:1 or 2:1 patient-to-nurse staffing ratio in intensive care units (ICU), as guided by a tool that accounts for patient acuity and anticipated care intensity.
Now, a new study co-authored by a Boston University School of Public Health (BUSPH) researcher finds these ICU staffing regulations led to only modest staffing increases, and were not associated with improved patient outcomes.
The study, published in Critical Care Medicine, found that the average patient-to-nurse ratio went from 1.38 patients per nurse to 1.28 patients per nurse after the law went into effect, while the risk of mortality and the risk of complications in Massachusetts’ ICUs remained stable.
“The Massachusetts regulations resulted in only minimal changes in nurse staffing, which likely explains the lack of changes to patient outcomes,” says study senior author Dr. Allan Walkey, associate professor of health law, policy & management at BUSPH. “Our results suggest that Massachusetts hospitals may have had adequate ICU nurse staffing prior to the law.”
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