Cincinnati Children's study says nurse to patient ratios do matter

May 8, 2013

Just weeks after Senator Barbara Boxer, D-Calif, proposed federal legislation mandating nurse staffing levels, Cincinnati Children's Hospital Medical Center is out with a study on the effect of nurse staffing ratios to hospital re-admissions.

Heather Tubbs-Cooley, PhD, RN, nurse scientist at Children's, is believed to be the first to look at how nursing shortages relates to pediatric re-admissions. Her team studied more than 90,000 children in 225 hospitals using survey and discharge data from California, Florida, New Jersey and Pennsylvania as well as the American Hospital Association Annual Survey from these four states.

She discovered that for each one patient increase in a hospital's average staffing ratio that increased the odds of a medical patient's re-admission within 15-30 days by 11 percent. For surgical patients the odds of re-admission were increased by 48 percent.

Tubbs-Cooley says she is not ready to endorse mandated staffing ratios.

"We have abundant evidence that better nurse staffing levels in hospitals are associated with better patient outcomes, but we lack robust data to guide decision-making regarding optimal staffing levels for a given unit or patient population. Producing that evidence will require different designs and methods than those we have relied on in the past."

She plans to test these research designs in other studies.

The Tubbs-Cooley study was published online in the Journal BMJ Quality and Safety in Health Care.