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Proper Nursing Staff Can Save Patient Lives and Reduce Healthcare Costs

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By Zenaida Gonzalez Kotala

As the presidential candidates stomp in Florida this week and toss about their ideas on how to make health care more affordable in America, a UCF Health Services Administration professor has completed a study that shows one way hospitals can save money.

Contrary to popular belief, having the proper number of registered nurses caring for patients may not cost more. Associate Professor Lynn Unruh's review found that in many cases it actually lowered the costs of giving care.

"As an economist, I know how it works," Unruh said. "It comes down to money. But the research shows that it makes economic sense to properly staff. We need more research to establish nurse to patient ratio standards, but the bottom line is that if you find the right balance you not only save lives, you save money."

Unruh was a pediatric nurse for more than 25 years before going back to school to earn a Ph. D in economics from the University of Notre Dame. Since 2000 she's been teaching and conducting research at the University of Central Florida, with the exception of a one-year fellowship at the Robert Wood Johnson Foundation August 2006 to August 2007.

Quality and access to care in the U.S. health care system are below what is available in most other developed nations, but the costs are higher, Unruh said. That makes finding ways to improve care and reduce costs critical.

Because of the absence of national standards for nurse-to-patient ratios, the severity of patients' injuries must be considered when determining the appropriate staffing levels, Unruh said.

"What may be a proper ratio in one area may not be adequate in another," she added. "We really need to develop those standards. But studies show that when the ratio is appropriate, the patient outcomes are better, nurses are more satisfied, and costs can be lower."

According to the Unruh's review published in this month's American Journal of Nursing (htpp://, hospitals with higher RN staffing levels experienced lower rates of deaths, pneumonia, post-operative complications, and other negative patient outcomes in. That means patients were healthier and insurance companies didn't have to spend extra money for added procedures.

In specialty units such as geriatrics or obstetrics, there were fewer incidences of falls and medication errors, which is not only good for patient well-being but also protects hospitals from lawsuits.

Unruh's review also found that nurses in better-staffed units were more satisfied and less likely to leave their jobs, saving hospitals the expenses of replacing them. It can cost as  much as $160,000 to hire and train a new nurse. 

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