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Clinical Systems Leadership

The Importance of Appropriate Nurse-Patient Ratios

To provide the highest level of health care to people, clinicians need access to certain things. These necessities can include technological tools, mentorship and work schedules that promote health and well-being for health-care providers themselves. Yet, there is another factor that can’t be overlooked: manpower.

If there are more patients than nurses available to treat them, hospitals, clinics and doctor’s office may run into trouble. It’s crucial to create and maintain an appropriate ratio to ensure the best healthcare service is provided to those who truly need it.

A federal regulation regarding nurse-patient ratios is pending.

A Masters of Science in Nursing will provide the regulatory education nurses need to understand important elements of their field, including nurse-patient ratios.

Federal law on hold

There is already a government regulation in place that requires certified hospitals participating in Medicare to ensure they have an adequate number of licensed registered and practical nurses, as well as other personnel, to provide care to all patients as necessary.

Yet, the proposed Registered Nurse Safe Staffing Act, which was introduced in April 2015, still has yet to be passed by Congress. The potential law calls for direct care nurses – along with managers – to work together to create registered nurse staffing plans to make institutions more effective and efficient. Under the Act, Medicare-participating hospitals would have to create a diverse committee to develop and enact these staffing programs and create monetary penalties for noncompliance.

The Registered Nurse Safe Staffing Act also ensures that RNs cannot work in specialty units unless they are trained or experienced with that specialty, including previous orientation and education. Complaint procedures and whistleblower protections are also included in the proposed law.

States take action

Since the aforementioned act has yet to be agreed upon by Congress, many states have decided to take action to ensure their own facilities are properly staffed. California was one of the first to do so, passing the RN Staffing Ratio Law in 1999. Hospitals were required to meet the regulations by January 2004. This regulation calls for a minimum nurse-patient ratio to be maintained at all times by specific unit. For example, in intensive and critical care there must be one RN to every two patients. California split these proportions down by departments including labor and delivery, operating rooms, pediatrics, emergency room and more.

Other states have followed suit over the years. Today, 14 have addressed nurse staffing in hospitals in their own legal guidance. According to Nursing World:

  • Seven states – Connecticut, Illinois, Nevada, Ohio, Oregon, Texas and Washington – require hospitals to have staffing communities that develop policies and nurse-driven ratio plans.
  • Five states – Illinois, New Jersey, New York, Rhode Island and Vermont – require a certain level of disclosure and/or public reporting.
  • Minnesota requires a Chief Nursing Officer or designee to develop – with the input of others – a core staffing program.
  • Massachusetts requires a 1:1 or 1:2 nurse-patient ratio depending on the stability of the patient. This is specific to those patients in intensive care.

Pre-determined nurse-patient rations offer many benefits to clinicians.

Benefits of nurse-patient ratios

With the push to create accurate and appropriate proportions of clinicians to patients happening across the country, it’s important to look at the advantages institutions gain from taking this action.

According to Nursing Times, some of the benefits include:

  • Lower patient mortality rates.
  • Reduced readmissions.
  • Decreased nurse burnout.
  • Higher job satisfaction.
  • Increased nurse retention.
  • Improved patient safety.

A Master of Science in Nursing can help RNs better contribute their insight to staffing decisions put in place by not only their state, but their institution.

Sources

https://www.law.cornell.edu/cfr/text/42/482.23

https://www.congress.gov/bill/114th-congress/senate-bill/1132

http://www.nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/2015-NR/ANA-Commends-Introduction-of-the-Registered-Nurse-Safe-Staffing-Act.html

https://www.cga.ct.gov/2004/rpt/2004-R-0212.htm

http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/State/Legislative-Agenda-Reports/State-StaffingPlansRatios

https://www.nursingtimes.net/roles/nurse-managers/the-effects-of-nurse-to-patient-ratios/5024051.article

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