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Nurse staffing study doesn't answer patient safety questions

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How many nurses does it take to effectively care for patients in Minnesota hospitals? That's the question at the heart of a study that's been conducted over the past 18 months by the state health department. After all that time, the answer is, "we don't know."

Not only is the issue important for patients, it was a central negotiating point between the state's nurses and hospitals in their contentious contract talks in 2010. Nurses argued that patients have better outcomes – are less likely to fall or suffer complications, for example – when more nurses are on duty and can give more attention to each patient.

The nurses union didn't win that argument in the 2010 contract talks, and even walked off the job for a day. But in 2013 the Legislature ordered the health department to study the correlation between nurse staffing levels and patient outcomes.

The results were reported to lawmakers last week without a definitive answer, because most hospitals didn't provide the necessary numbers to the researchers, according to the Associated Press.

The Minnesota Nurses Association criticized the hospitals for not turning over the necessary information, the Star Tribune reports.

But the hospitals responded that they simply didn't collect the kind of detailed numbers that were being called for.

The health department instead looked at existing research and determined that higher nurse staffing has been associated with better patient outcomes, according to the Star Tribune.

But it doesn't go so far as to prove there's a cause and effect, Health Commissioner Ed Ehlinger wrote in a letter to legislators last week.

The results “do not identify points at which staffing levels become unsafe or begin to have negative effects on outcomes,” Ehlinger wrote, according to the Star Tribune.

The Minnesota Hospital Association notes that patients are cared for by many different medical professionals, not just nurses, so the impact of nursing staff levels on patient outcomes is hard to measure.

The nurses union counters, however, that patient care has suffered because of lower nurse staffing.

"In 2014, Minnesota nurses documented 2,148 instances of unsafe staffing with the potential to substantively impact patient care. Even one such instance would be concerning—but even scarier is that the reported rate of unsafe staffing has doubled over the past three years." 

The nurses' contract will be up next year, and it's unclear how the new report will affect those negotiations.

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