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Nurs Econ. 2009 Sep-Oct;27(5):302-14, 331.

Cost savings associated with increased RN staffing in acute care hospitals: simulation exercise.

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Minnesota Evidence-Based Practice Center, Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA.


Increasing nurse-to-patient staffing has been recommended as a means to improve patient safety. In this study, researchers analyzed the savings-cost ratio of increased RN-to-patient ratios for patients in ICUs and patients in surgical and medical units based on a meta-analysis of published observational studies. Increased RN staffing was associated with lower hospital-related mortality and adverse patient events and generates societal net savings from avoided patient adverse events. This finding appears to hold in ICUs and, to some extent, in surgical units, but not in medical units. Hospitals do not experience sufficient monetary benefit from reduced length of stay corresponding to an increased RN staffing. Policy decisions about RN staffing should include cost-utility analyses.

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