Mandating nurse patient ratios
They also recommended three new "one-to-one" staff positions to allow high-acuity patients or those with multiple diagnostic tests scheduled to be assigned to a dedicated nurse.
Four years ago, Massachusetts passed a law requiring 1-to-1 or 2-to-1 patient-to-nurse staffing ratios in intensive care units, as guided by a tool that accounts for patient acuity and anticipated care intensity.
When Riverside Methodist Hospital in Columbus, Ohio, experienced a period of multiple changes and high nurse turnover in the 32-bed neurocritical care unit, two of the unit's nurses launched a workflow study to assess relationships between neurological assessment, documentation, traveling with patients for diagnostic tests, and the effects of patient acuity and nurse experience.At the time, there was speculation in the nursing community that other states would quickly follow suit, and mandatory ratios would spread across the country. In fact, this November, Massachusetts voters rejected a law that would establish mandatory staffing ratios in the state.Almost 20 years later, California remains the only state to require nurse-to-patient ratios to such a broad extent. Certainly, some of it is politics and how successfully those for or against ratios lobby lawmakers and the public to support their stance.The study calls for developing broader workload strategies to ease nurses' stress and improve care quality.
The researchers evaluated the relationships between objective and subjective workload measures and quality of care and found the nurses' perceived workloads had a consistently strong influence on missed essential care.The findings are the latest in a long line of studies showing that physicians are the nation’s highest-paid...