While we continue to push for greater improvements in health care practice and delivery, we should still take time to stop and be grateful for the improvements that have already taken place in certain states through dedicated advocacy. You will recall that in 1999, California became the first state in the nation to mandate minimum nurse-to-patient ratios. These ratios were phased in between 2004 and 2008. According to a report by California Healthline, California's mandatory nurse-patient ratios have helped create a decline in 30-day inpatient mortality rates.
California's landmark law set parameters that included the following nurse-patient ratios for acute care facilities:
· Nurses must not care for more than six patients in a psychiatric unit
· Nurses must not care for more than five patients in a medical-surgical unit
· Nurses must not care for more than four pediatric patients
· Nurses must not care for more than three patients in a labor & delivery unit.
· Nurse must not care for more than two intensive care patients
The idea behind the law was to relieve overburdened nursing staff so that they can be more attentive to individual patients, thereby helping to produce better patient outcomes. Many in the health care field were eager to see if this law would help produce the desired results. Now, according to a study supported by the Robert Woods Johnson Foundation and the NIH's National Institute of Nursing Research, those positive outcomes have been confirmed.
The principal findings of the study were that lower nurse-to-patient ratios like those required in California are associated with significantly lower patient mortality. Also of note is that nurses with lower nurse-patient ratios reported less burnout and job dissatisfaction, which is something to think about when taking the nationwide nursing shortage into consideration. Nurses also reported in the study that they provided a better quality of care to patients when working with lower ratios. The study concluded that low ratios are "predictive of better nurse retention in California and in other states where they occur."
A few other states have enacted laws that mandate lower nurse-patient ratios; other states are considering bills that would do the same. There's even nurses advocating for Congress to mandate a federal standard for nurse-patient rations.
Do you advocate for safe nurse-patient ratios in your state or for a nationwide mandate? Why or why not?