Mandating nurse staffing ratios

The study found that ratios in California were associated with lower mortality rates.Another study in 2017 published in the found that higher nurse staffing ratios were tied to decreased survival likelihood.Higher staffing ratios equals’ higher patient mortality, greater job satisfaction, and decreased nurse job turnover.

California was the first state to implement nurse to patient ratios in acute care hospitals and as of 2011, 14 other states have enacted some type of regulation related to nurse staffing level and 17 states have introduced legislation mandating minimum nurse ratios.

Even Pamela Cipriano president of the American Nurses Association is quoted as saying in a statement “The rigid, one-size-fits-all approach proposed by the ballot initiative failed to acknowledge the complexities of staffing and undermined nurses’ professional autonomy and decision making in determining staffing on their units.” There is much argument that with strict mandates there is steep fiscal costs and hospital administrators would not be able to have the authority to make changes.

Jan Emerson-Shea, vice-president of external affairs for the California Hospital Association, seconds It’s impractical for any hospital to keep the ratio of nurses to patients within a set limit, she argues, with all the inevitable ups and downs of hospital life—a disaster or violent crime causing a sudden inrush of many patients needing urgent care, for instance, or a few nurses calling in sick on the same day.

Media headlines boast “Implementing mandated nurse-to-patient staffing ratios would cost Massachusetts providers an estimated 6 million to 9 million a year, net relatively minimal savings and have an insignificant impact on quality, according to a new analysis from the Massachusetts Health Policy Commission.” An independent state agency that monitors hospital spending stated that it would cost billions.

Perhaps these headlines are what swayed voters away from passing safer staffing mandates.

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State health officials developed the specific nurse-to-patient ratios over time, with input from different stakeholders.

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