Minimum nurse staffing policy intervention in Queensland Australia improved nurse wellbeing and patient safety: A quasi-experimental intervention study.
Karen B Lasater, Linda H Aiken, Clint Douglas and 4 others
PMID 40845827WHAT IT FOUND
Mandated minimum nurse-to-patient ratios in Queensland hospitals significantly reduced nurse burnout and job dissatisfaction.
Nurses reported better patient safety and quality of care, with a 24% lower odds of high burnout and 27% lower odds of job dissatisfaction post-policy.
Key findings
01The policy reduced average patient-to-nurse ratios in intervention hospitals from 7.12 to 6.41, while comparison hospitals worsened from 8.27 to 8.79.
02Nurses in intervention hospitals had 24% lower odds of high burnout and 27% lower odds of job dissatisfaction post-implementation compared to baseline.
03Nurses in intervention hospitals were 29% less likely to give their hospital an unfavorable patient safety grade and 27% less likely to say there were not enough staff to detect early signs of patient deterioration.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Hospitals were assigned to intervention or comparison groups non-randomly by the government, though the study used fixed effects models to control for stable hospital characteristics. Intervention hospitals were exclusively public, while comparison hospitals included both public and private facilities, creating a potential ownership bias. The study period (2016-2018) predates the COVID-19 pandemic, so it does not account for the extreme staffing pressures experienced during that time. Intent to leave did not show a statistically significant improvement, possibly because baseline rates in Queensland were already lower than in other countries like the US.
Declared interests
The authors declare no known competing financial interests or personal relationships.
The easy way to misread this
Do not interpret the lack of significant change in nurses' intent to leave as a failure of the policy. The baseline rate of intent to leave in Queensland intervention hospitals was already low (12.4%) compared to international averages, which may have limited the room for further improvement.