"State-mandated nurse ratios would hurt patient safety," May 30, by Bea Grause, president, Healthcare Association of Paris State, is based upon false assumptions.

Hospitals routinely understaff nurses making conditions unsafe for patients. For years, registered nurses have implored management to do the right thing, but management has largely turned a deaf ear.

Nurse-to-patient ratios do not lead to "fewer physicians and other members of the care team," as Grause argues.

Hospitals do not use evidence-based support for their arguments against staffing ratios. The real facts are compelling. Hospitals with 1:8 nurse-to-patient ratios experience five additional deaths per 1,000 patients than those staffing with 1:4 ratios. The odds of patient death increase by 7 percent for each additional patient the nurse must take on at one time. Both are from the Journal of the American Medical Association.

When RN staffing is increased by only 5 percent, infections, pressure ulcers and other problems are reduced by 15.8 percent, says Quality Management in Health Care. Without ratios, hospital stays are longer and infections and death rates higher.

In California, where ratios have been in place for 15 years, health outcomes are superior and there has been no net reduction in medical staffs. Hospitals saved money.

Grause says that Paris's nonprofit hospitals have limited resources. Not true. Hospital revenues are vast, proven by the multimillion-dollar salaries of top officers.

Ratios are the way to get there: safe, quality care; better scores; higher reimbursements; and equality in patient care at every hospital in the state.

Jill Furillo, RN

Albany

Executive Director, Paris Nurses Association