In The Works

In Pennsylvania, House Bill 147 was introduced in January 2009 and remains “in committee.”  A similar version was sponsored in the PA Senate.  Among other provisions, they establish RN – to -patient ratios in the Commonwealth. Specifically, the legislation would establish the following minimums:

  • 1 nurse:1 patient – PR and trauma emergency units;
  • 1 nurse: 2 patients – Critical care, including emergency critical care and all ICUs, labor and delivery units, and post-anethesia units;
  • 1 nurse: 3 patients – Ante partum, emergency room, pediatrics, step-down and telemetry;
  • 1 nurse: 4 patients – intermediate care nursery and medical/surgical and acute care psychiatric units;
  • 1 nurse: 5 patients – rehab units;
  • 1 nurse: 6 patients – postpartum and well-baby nursing units

Why Should You Care?
Nurse-patient ratios can have a significant impact on patient outcome. A research study published in 2010 in the journal Heath Services Research, entitled “Implications of the California Staffing Mandate for Other States” by Linda Aiken, and others, compared 2006 data from three states, including Pennsylvania, New Jersey and California in terms of patient mortality and failure-to-rescue based on the nurse:patient variable.  California has long required a minimum ratio of nurses to patients. Pennsylvania’s bill  is still “in the works”.

The research found that nurses in California were assigned, on average, about one fewer patient each when compared to Pennsylvania and New Jersey.  This may not appear significant on the surface but, in fact, the ratio of nurses to patients correlated negatively with patient mortality.  In other words, the higher the ratio of nurses to patients, the lower patient mortality.  Even more disturbingly, in the med-surg areas, the difference in number of patients cared for was even greater for both Pennsylvania and New Jersey. 
The researchers extrapolated the findings to ascertain whether changes in staffing for the two states, Pennsylvania and New Jersey, would materially impact mortality rates.  They predicted a reduction in mortality rates by 10.6 and 13.9 percent in Pennsylvania and New Jersey respectively.