Does mandating nurse patient ratios improve care
The revenue code data, used to charge for inpatient nursing care, could be used to benchmark and evaluate inpatient nursing care performance by case mix across hospitals. In the past several years, there has been a growing need for more registered nurses in hospitals due to rising acuity of patients and shorter lengths of stay. A nursing intensity adjustment to hospital payment, such as that described above, has already been endorsed by national nursing organizations. The safety and quality of patient care is directly related to the size and experience of the nursing workforce. Numerous studies reveal an association between higher levels of experienced RN staffing and lower rates of adverse patient outcomes.
Seven states[b] require hospitals to have committees responsible for staffing policy, and five states[c] require disclosure or public reporting of staffing. More legislation is being introduced, including proposals by three states[d] to create staffing committees, proposals by three states[e] to require public disclosure laws, proposals by seven states[f] to set staffing ratios, and four states[g] with alternative nurse staffing bills. In 2006, Florida passed a safe staffing ratio law similar to California’s. Clarke, Linda Flynn, Jean Ann Seago, Joanne Spetz, and Herbert L. “Implications of the California Nurse Staffing Mandate for Other States.” The Department for Professional Employees, AFL-CIO (DPE) comprises 21 AFL-CIO unions representing over four million people working in professional and technical occupations.
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.
Efforts to implement this model nationwide within the next few years have already been initiated. Inpatient working conditions have deteriorated in some facilities because hospitals have not kept up with the rising demand for nurses. Adjustment of inpatient care reimbursement for nursing intensity.
This article will argue for the benefits of implementing a nursing intensity adjustment for nursing care by briefly reviewing the process by which nurses lost their economic independence; describing the gap between the supply and demand for registered nurses; presenting the arguments for and against mandatory, nurse-to-patient staffing ratios; offering a different approach for increasing the number of registered nurses at the bedside, namely nursing intensity billing; proposing sources of funding to pay for nursing intensity billing; and identifying limitations of nursing intensity billing. This situation has motivated some state legislatures to enact or consider regulatory measures to assure adequate staffing.
There is a proven method to save patient lives and save hospital money — mandated minimum nurse-to-patient staffing ratios. Jan Schakowsky (D-Ill.) introduced her The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act to improve patient quality of care by establishing a requirement for nurse-to-patient ratios that put patient safety first.