Disclosure Law Improves Nurse Staffing Ratios in New Jersey

Nurse Leader Insider, April 18, 2019

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By Michelle Clarke

In 2008, New Jersey began requiring hospitals and nursing home to publicly report the number of patients per nurse and a recent study out of Rutgers, found the law has led to better nursing staffing ratios.

The study, published in Policy, Politics, & Nursing Practice is the first study of its kind to evaluate the effectiveness of this particular requirement. Since the law went into effect, the number of patients decreased in 10 out of 13 specialty areas of care.

“Nurse staffing, particularly for registered nurses, has been shown to have a direct impact on patient outcomes, such as rates of infection, falls, heart attacks, and even death. Insufficient nurse staffing also can affect a patient’s length of stay in the hospital,” said lead research Pamela de Cordova, PhD, RN-BC, an assistant professor at Rutgers School of Nursing, in a release. “By reporting and analyzing the data and ensuring that nurses are included in staffing discussions, patient outcomes can be improved.”

The following specialties showed the most significant change of RN staffing:

    Neonatal ICU, number of assigned patients decreased from 2.1 babies assigned in 2008 to 1.9 babies assigned in 2015
    Pediatrics, number of patients decreased from 2.7 children in 2008 to 2.4 children in 2015
    Medical-Surgical unit, number of patients decreased from 5.5 patients assigned in 2008 to 5.1 patients assigned in 2015

Only the adult open psychiatric specialty saw an increase between 2008-2015 in their staffing ratio. The number of patients assigned to an RN during this time increased from 5.8 patients per nurse to 6.1 patients. The study found that the closed child psychiatric and adult ICU specialties saw no change in the number of patients assigned to RNs.

Hospitals and nursing homes are mandated by the law to submit detailed information about nurse staffing levels, including the number of patients assigned to each staff type, within sight of the patients, to the New Jersey Department of Health, which shares the information online.

New Jersey is one of eight states (five required by law and the other three, electively) that require hospitals and nursing homes to report staffing ratios.

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