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Study: Hospitals add higher skilled nurses in response to mandate

Sacramento Business Journal, 7/18/11

By: Kathy Robertson
Monday, July 18, 2011
Sacramento Business Journal

California hospitals have added registered nurses and increased access to professional nursing care since the state’s landmark nurse-to-patient staffing law was implemented, a new study concludes.

The report, which appears in the July edition of the journal Health Affairs, refutes worries by opponents to the law that hospitals would respond by disproportionately hiring lower-skilled licensed vocational nurses.

Overall, the study found the staffing law resulted in roughly an additional half-hour of nursing per adjusted patient day beyond what would have been expected without the law, the study conducted by University of Pennsylvania.

“We found that California’s mandate did not reduce the nurse workforce skill level as feared,” the report states. “Instead, California hospitals on average followed the trend of hospitals nationally by increasing their nursing skill mix, and they primarily used more highly skilled registered nurses to meet the staffing mandate.”

The study directly compared staffing at California hospitals to facilities in New York, Texas, Florida — the four other states with the most hospitals.

There was a notable increase in staffing in California hospitals — from 6.44 hours per adjusted patient day in 2004 to 7.11 hours per adjusted patient day in 2008 — the implementation period for the new law. Staffing went from 5.75 hours to 6.22 hours in the comparison hospitals over the same period.

“This study brings home once again what California nurses could readily tell you,” Deborah Burger, a registered nurse who is co-president of National Nurses United and the California Nurses Association.

It took the California Nurses Association — sponsor of the measure — 10 years to get it signed into law. Former Gov. Gray Davis signed it in 1999, but ratios were phased in from 2004 through 2008.

Officials at the California Hospital Association were unavailable for comment on the study.

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