Pennsylvania health care facilities have fewer registered nurses per patient than the U.S. average, according to a new study by the Pennsylvania Joint State Government Commission.

The study cited research from the University of Pennsylvania School of Nursing showing that registered nurses log about 7.5 hours per patient day nationally, compared to about 7 hours in Pennsylvania and 10 hours in California.

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California is currently the only state that mandates minimum nurse-to-patient ratios across all units, the study said. Researchers estimated that if Pennsylvania matched those ratios, there would have been 11 percent fewer deaths following surgery in Pennsylvania.

California's ratios range from one nurse for two patients to one nurse for six patients, depending on unit. The study quoted data from 2006 showing that Pennsylvania nurses were responsible for an average of 2.2 to 8.8 patients. 

The study did not include ratios for individual hospitals, noting that data leaves much to be desired.

The problem is not a shortage of nurses, the study said, noting that the number of new graduates entering the workforce nationally has more than doubled since 2001. Projections show Pennsylvania will have have a surplus of 25,800 RNs by 2025.

But, the study said, “Hospitals vary significantly from one to the next in terms of nurse staffing, which contributes to disparities in quality of care across the state. This variation is much greater than can be justified by differences in patient need and is not in the public interest.”

The study stops short of recommending mandated nurse-to-patient ratios in Pennsylvania, but suggests the following:

  • Improved nurse workforce data collection and analysis.
  • A public reporting system for hospital staffing levels.
  • Considering consistency of nurse staffing during “off-shifts” (nights, weekends, holidays).
  • Improving the nurse work environment.
  • Developing a plan to encourage more nurses to get a bachelor’s degree in nursing.
  • Extending the state’s whistleblower protection law to nurses.

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