It’s an issue that crops up at the State House every few years and has never been resolved: Should there be a law limiting the number of hospital patients under the care of a nurse at any given time?
This question is back before state lawmakers in this session but this year it may also be on the election ballot.
Is there proof that assigning each nurse no more than four patients would improve care? At a State House hearing on Monday, Karen Coughlin, vice president of the Massachusetts Nurses Association, said yes. Coughlin pointed to one study in particular, “which found that every additional patient assigned to a nurse over four resulted in a 7 percent increase in the risk of death for all the patients under that nurses care.”
But this research, published in the Journal of the American Medical Association, also says it’s not clear exactly how many patients a nurse can care for, but five or six would be wise. California, the only state with a nurse-to-patient ratio law, has nurses caring for five general surgery patients and two in the intensive care unit.
Boston College nursing professor Judith Shindul-Rothschild argues that legal patient limit translates to better care for at least one disease in California as compared to Massachusetts.
“When we look at our patient outcomes for heart failure readmission, for instance, there is a difference,” Shindul-Rothschild said. “It’s not just staffing, but it’s partly due to staffing.”