Massachusetts nurse staffing regulations did not reduce patient mortality, complications in ICUs, Beth Israel study finds

A 2014 Massachusetts law mandating patient-to-nurse staffing ratios in intensive care units statewide resulted in nurse staffing increases but not improved patient outcomes, according to a study published in Critical Care Medicine.

The study — led by physician researchers at Boston-based Beth Israel Deaconess Medical Center — found that nurses in Massachusetts ICUs saw more patients at a given time pre-mandate (1.38) versus post-mandate (1.28). But researchers said they saw a similar increase in other states without state-mandated ICU staffing regulations.

The study also found no link between Massachusetts ICU nurse staffing regulations and the number of patients who died in Massachusetts ICUs. Additionally, researchers said complications and do-not-resuscitate orders in Massachusetts' ICUs did not change significantly after the law's implementation.

"State regulation of patient-to-nurse staffing with the aid of patient complexity scores in intensive care was not associated with either increased nurse staffing or changes in patient outcomes," the study's authors concluded.

The study examined data from 246 U.S. hospitals to compare Massachusetts ICUs before, during and after the implementation of 1:1 or 2:1 patient-to-nurse ratios with states that don't have mandated ICU nurse staffing ratios.

It comes amid a proposed Massachusetts November ballot initiative to mandate nurse staffing ratios in all areas of Massachusetts hospitals. Question 1, proposed by the Massachusetts Nurses Association, calls for one nurse to be responsible for no more than four pediatric patients and no more than five psychiatric patients at a given time. Different guidelines would apply with sicker patients, according the Boston Globe. Staffing ratios would also differ by unit.


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