reported directly by the hospital. In general, the hospital-reported ratios were leaner (fewer nurses for the patients) than those computed. These two methods yielded the average nurse-to-patient ratios and ranges of staffing levels by shift and rural/urban hospital status shown in Tables 5-4 and 5-5, respectively. The range of nurse staffing levels is shown by the reported number of patients per RN displayed in quartiles in Table 5-5.

A survey of Pennsylvania RNs working in hospitals in 1999 identified medical–surgical nurses and asked them to provide (for the most recent shift they had worked) information on the type of shift they had worked (i.e., day, evening, or night), the number of patients in their unit during that shift, the number of patients assigned to them, and the number of RNs who had worked in their unit during that shift. The average number of patients assigned to these medical–surgical nurses ranged from six to eight, with

TABLE 5-4 Average Number of Patients per RN, by Shift and Rural/ Nonrural Location, in California

Shift

Rural with 12-Hour Shifts

Nonrural with 12-Hour Shifts

Rural with 8-Hour Shifts

Nonrural with 8-Hour Shifts

Computed number of patients per RN

Day shift

4

4.4

6.2

4.2

Evening shift

NA

NA

3.0

4.7

Night shift

4.4

5.2

3.0

5.7

Reported number of patients per RN

Day shift

6.7

5.9

6.8

6.1

Evening shift

NA

NA

6.7

6.9

Night shift

7.4

6.9

7.3

8.2

NOTE: NA = not applicable.

SOURCE: Spetz et al. (2000).

TABLE 5-5 Quartiles of Staffing Data in Medical–Surgical Units, in California

 

Reported Number of Patients per RN, by Shift

Shift

25%

50%

75%

100%

Day shift

5

6

7

12

Evening shift

5.1

7

8

12

Night shift

6

8

9

26

 

SOURCE: Spetz et al. (2000).



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