By Bobby Calvin
Sacramento Bee
April 21, 2010

A new study on nurse staffing levels was hailed by the California Nurses Association on Tuesday as proof that the state's nursing-ratio law is saving lives.

If similar laws were enacted in such states as Pennsylvania and New Jersey, the number of patient deaths in those states could be reduced by as much as 14 percent, according to the study conducted by researchers at the University of Pennsylvania and published in the journal Health Services Research.

"We feel vindicated. We knew this would work," said Geri Jenkins, a registered nurse at the University of California, San Diego, Medical Center and a member of the CNA's council of presidents.

In 1999, California was the first in the nation to establish minimum nurse-to-patient staffing levels at hospitals across the state. The law was implemented in January 2004, despite fierce opposition from hospitals and Gov. Arnold Schwarzenegger.

Since then, 14 states and the District of Columbia have enacted similar staffing laws, and 17 other states are considering legislation, according to the study.

Sen. Barbara Boxer, D-Calif., introduced federal legislation to extend minimum staffing levels across the country.

According to the study, lower nurse-to-patient ratios "have sizable effects on surgical patient mortality."

Researchers used a 2006 survey of 22,336 nurses and patient discharge data in California, New Jersey and Pennsylvania to establish a relationship between the number of deaths and nurse staffing levels.

The researchers concluded that there would have been nearly 11 percent fewer surgical deaths in New Jersey if it had nurse staffing ratios equivalent to those in California. In Pennsylvania, the study found, there would have been about 14 percent fewer deaths.

"In these two states alone, 468 lives might have been saved over the two-year period just among general surgery patients if the California nurse staffing levels were adopted," said Linda Aiken, the lead author and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

"Because all hospitalized patients are likely to benefit from improved nurse staffing, not just general surgery patients, the potential number of lives that could be saved by improving nurse staffing in hospitals nationally is likely to be many thousands a year," she said.

Based on its nurses survey, the study found substantial compliance with California's law, but it also indicated that some hospitals weren't always adhering to staffing requirements.

On average in 2006, nurses in California cared for one less patient than their counterparts in New Jersey and Pennsylvania.

"One less patient makes a big difference," said Shirley Toy, a registered nurse at the UC Davis Medical Center.

"The less patients you have, the more time you have to spend with a patient," she said. "And if you're the patient, you want your nurse to give you all the care you need."