Mandating nurse patient ratios

22-May-2016 11:37 by 8 Comments

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The cookies contain no personally identifiable information and have no effect once you leave the Medscape site.As more than a dozen states consider laws to establish hospital nurse-to-patient ratios, what has been the experience in California—the first state to establish such a rule—since the policy took full effect in 2005?

The other problem Emerson points to is with ratios in the emergency room, where the ratio is one nurse to four patients.

Currently, 15 states (CA, CT, IL, ME, MN, NV, NY, NJ, NC, OH, OR, RI, TX, VT, and WA) plus the District of Columbia have enacted legislation or adopted regulations to address nurse staffing.

Of these states, seven (CT, IL, NV, OH, OR, TX, and WA) require hospitals to have staffing committees to address staffing plans and policies; one state (CA) requires the minimum nurse-patient ratio to be maintained at all time; and five states (IL, NJ, NY, RI, and VT) require public disclosure or reporting.

He says similar legislative proposals are working their way through 13 other states as well.

"We know 90% of our nurses support and desperately want it," he says.

In a statement on its website, ANA says that it “supports a legislative model in which nurses are empowered to create staffing plans specific to each unit.

This approach aides in establishing staffing levels that are flexible and account for changes; including intensity of patient’s needs, the number of admissions, discharges and transfers during a shift, level of experience of nursing staff, layout of the unit, and availability of resources (ancillary staff, technology etc.).” Rather than mandated fixed ratios or a one-size-fits-all approach, this type of model would give hospitals the flexibility to develop staffing plans that fit their particular institutional and patient needs.

"The only time a hospital can go above this ratio is when there is a local or state declared emergency.

This rigid ratio is one of the reasons that ER waiting times can be lengthy—especially if there is an unexpected surge of ER patients because of a car crash.

Albeit controversial, mandating nurse staffing ratios is one way of approaching staffing in patient care areas.

The American Nurses Association (ANA) has been outspoken on this issue, calling for legislation mandating staffing plans and ratios.

And how much has the increased expense affected hospitals' bottom lines? As one might expect, hospitals and nursing organizations are divided in their perception of how things are going.