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The RN4CAST Australia study evaluates whether new hospital nurse staffing regulations improve patient outcomes and conditions for nursing practice.

From right: Center Director, Dr. Linda H. Aiken with John Wakefield, Deputy Director General, Que...From right: Center Director, Dr. Linda H. Aiken with John Wakefield, Deputy Director General, Queensland Health; Dr. Diana Schmalkuche, Director of Nursing-Workforce Sustainability, Queensland Health; Dr.Shelley Nowlan, Chief Nursing and Midwifery Officer for Queensland; Dr. Patsy Yates, Dean of the Nursing School, Queensland University of Technology; and, CHOPR Associate Director, Dr. Matthew D. McHugh

Recognizing the importance of adequate nurse staffing, the Queensland Government may legislate minimum nurse-to-patient ratios as a means of assuring a safe work environment to promote optimal patient outcomes.

About Queensland Health

Queensland Health GovQueensland Health is a Department of the Government of Queensland which operates and administers the state’s public health system. The Austrialian governmental agency commissioned the University of Pennsylvania and the Queensland University of Technology to independently evaluate whether new hospital staffing regulations going into effect 1 July 2016 to improve patient outcomes and conditions for nursing practice.

University of Pennsylvania Partners

Dr. Linda H. Aiken is the Claire M. Fagin Leadership Professor of Nursing; Professor of Sociology and the Director, Center for Health Outcomes and Policy Research. Dr. Aiken is among the most respected health services researchers in the world having received virtually all of the research honors in her field. She is a nurse and a sociologist and holds an endowed professorship at the University of Pennsylvania in nursing and sociology. 

Dr. Matthew D. McHugh is the Independence Chair Nursing Education and the Associate Director, Center for Health Outcomes and Policy Research. Dr. McHugh draws on his expertise in nursing, law, public health, and health services research to conduct studies demonstrating nursing’s position as a force for quality, equity, and innovation in health services. He has carried out several studies evaluating nurse-to-patient ratio policy implementation in the U.S. His work has advanced the field of nursing outcomes and policy research by showing the value of investing in nursing as a vehicle to achieve a higher functioning health care system

Dr. Douglas Sloane is a Sociologist and an expert on survey methods and longitudinal study design at the University of Pennsylvania.  Dr. Slo5ane has led the design of many of our studies.

Dr. Herbert Smith is Professor of Sociology and Director of Penn’s Population Studies Center at the University of Pennsylvania. He is an expert on survey research design, measurement, and social statistics

Queensland University of Technology Partners

Dr. Patsy Yates is the Head of School, Queensland University of Technology; Professor, School of Nursing, Queensland University of Technology and Institute of Health and Biomedical Innovation. Professor Patsy Yates is an internationally recognized research leader in nursing having made substantial contributions to health services research and its impact on policy and practice.  In the past 10 years, she has received nearly $10 million in competitive research funding. She has also received over $40 million in contract research funding for federal and state governments and leading non-government organizations.  Her work has had a significant impact on health care delivery in Australia.

Dr. Clint Douglas, Associate Professor, QUT and Visiting Research Fellow, Royal Brisbane & Women’s Hospital and has a strong track record in health services and patient safety research.

Dr. Carol Windsor, Associate Professor and Acting Director of Research and has 20 years’ experience in research around nursing work and nursing organisations.

Queensland Health Study In The News

Nurse-to-patient ratio legislation introduced. Queensland Government, 1 Dec 2015

Nurse-to-patient ratios Office of the Chief Nursing and Midwifery Officer, Queensland Health, 15 Oct 2015

Nurse to patient ratios Information sheet, Queensland Health, 15 Oct 2015, updated May 2016

Nurse to patient ratios, Questions and Answers, Queensland Health, 15 Oct 2015, updated May 2016

Research points to patient safety in nurse numbers, Health Times, 23 Nov 2015, updated  8 Feb 2016

Find out why this study is so important to nurses in Australia, read the related findings in the US and abroad in the published papers.

1. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet (2014), Aiken, LH, Sloane, DM, McHugh, MD. (Download)

2. Implications of the California nurse staffing mandate for other states. Health Services Research (2010), Aiken LH, Sloane DM, Cimiotti JP, Smith, H. (Download)

3. Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction. JAMA (2002), Aiken, L. H., Sloane, D. M., & Silber, J. (Download)

4. An increase in the number of nurses with baccalaureate degrees is linked to lower rates of postsurgery mortality. Health Affairs (2013). Kutney-Lee A, Sloane DM, Aiken LH (Download)

5. Contradicting fears, California’s nurse-to-patient mandate did not reduce the skill level of the nursing workforce in hospitals. Health Affairs (2011). McHugh, MD., Sloane, DM, & Aiken, LH (Download)

6. Impact of nurse staffing mandates on safety-net hospitals: lessons from California. Milbank Quarterly (2012). McHugh MD, Brooks-Carthon JM, Sloane DM, Aiken LH (Download)