clinical ROUNDS

June 2010 
Volume 40  Number 6
Pages 21 - 23
  PDF Version Available!

In a major study, nurse researchers found that state-mandated minimum nurse-to-patient staffing ratios were associated with significantly lower patient mortality. Although many states have regulations or pending legislation addressing nurse staffing levels, only California currently requires minimum nurse-to-patient ratios in acute care hospitals.Researchers compared patient outcomes in California with those in Pennsylvania and New Jersey–two states that hadn't enacted nurse staffing legislation in 2006, the year from which study data were obtained. Results were based on hospital discharge databases and survey data from 22,336 hospital staff nurses in the three states in 2006, 2 years after the staffing legislation was enacted in California.Compared to nurses in Pennsylvania and New Jersey, California nurses cared for one less patient on average, and two fewer patients on medical and surgical units. Besides lower patient mortality, improved nurse staffing was associated with less nurse burnout and more job satisfaction predictive of better nurse retention.The researchers found "little evidence of unintended consequences of the California legislation that are likely to negatively affect the quality of the nurse work environment or patient care...The nursing skill mix in California hospitals appeared to improve and there is much research evidence that more RNs...are associated with better patient outcomes." Most California nurses reported that the legislation has achieved the intended purpose of reducing nurse workloads and improving quality of care.Source: Aiken LH, Sloane DM, Cimiotti JP, et al. Implications of the California nurse staffing mandate for other states. Health Serv Res. Published online April 9, 2010.The American College of Cardiology and the American Heart Association (ACC/AHA) have issued new professional guidelines for treating thoracic-aortic disease (TAD), including aortic dissection and aortic aneurysm. The guidelines are accompanied by a

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