Does mandating nurse patient ratios improve care

Aiken and her colleagues investigated how nurse workloads compared in three states, California, New Jersey, and Pennsylvania.Aiken examined how patient mortality and failure-to-rescue (FTR), incidents where hospital doctors, nurses, or caregivers fail to notice symptoms or respond adequately to signs that a patient is dying of preventable complications, are affected by differences in nurse workloads.Linda Aiken, Ph D, RN and her colleagues studied the effectiveness of the staffing ratios mandated in California. Aiken’s findings have important implications beyond California.Staffing ratios are designed to improve patient mortality and nurse retention.Registered nurses shall also have the obligation to act in the exclusive interest of their patients, and the right to be patient advocates.Nurses are increasingly put into impossible situations by hospital managers who demand they care for more patients than is safe.

The American Nurses Association (ANA) supports a legislative model in which nurses are empowered to create staffing plans specific to each unit.The costs associated with the additional registered nurses that will be needed for the higher, mandated ratios will not be offset by additional payments to hospitals, resulting in mandates that will be unfunded. An alternative approach would be to provide a market-based incentive to hospitals to optimize nurse staffing levels by unbundling nursing care from current room and board charges, billing for nursing care time (intensity) for individual patients, and adjusting hospital payments for optimum nursing care. Vol12No03Man01 Key words: nurse staffing; nursing minimum data set; diagnosis related group; cost of care; nursing intensity; health services research; nurse-to-patient staffing ratio; nursing workforce. 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.).Establishing minimum upwardly adjustable staffing levels is statute may also aide the committee in achieving safe and appropriate staffing plans.