Nurse to Patient Ratio Policy - Coursework Example

Nurse to Patient Ratio Policy Nurse to Patient Ratio Policy The issue of a growing population is making it harder for hospitals toturn away patients. This has led to an increase in demand for nurses who have to care for more than five patients at any given time. This has brought on a debate in the past as to whether such numbers affect the overall care of the patient, the quality of care provided, and even job satisfaction among the health caregivers. It is my belief that in order to increase the quality of care that patients in a given health facility receive, it is vital for the nurse to patient ratio be revised. Focus should be placed on whether one nurse can cater to a smaller number of patients, hence; providing all the necessary attention and care needed (Aiken et al., 2008). This may work toward ensuring that the emotional stability of both the patient and nurse is maintained. This paper will examine how such a revision may guarantee proper functioning of the nursing fraternity in terms of provision of care, and how this might increase satisfaction among the nurses and patients. It is clear from different books and articles present that the issue of mandatory nurse to patient staffing ratios is not new to the healthcare system. This debate probably goes back a decade before significant change, some of which can now be seen, could be made in the present day healthcare field. In 1999, a bill was passed into law by Gray Davis who was the Governor of California, which established that health services in the state needed to adopt regulations on minimum nurse to patient ratio staffing. This came after growing concern on the safety of the patients in the care of different health facilities. Assembly bill 394 was aimed at improving the quality of care, and the safety of patients. It also tried to reduce the nurse to patient ratios that existed at the time, which were associated with negative outcomes among the patients and loss of nurses (Sloan & Chee-Ruey, 2012). According to Aiken et al., different aspects of the nurse to patient staffing ratios led to higher patient mortality, nurse dissatisfaction, and even medical errors. This was in an article published in the Journal of the American Medical Association. Furthermore, nurses who happen to care for a significantly larger number of patients tend to be overworked and may fall short of what is expected of them in their respective healthcare facilities. In my opinion, Staffing, often seen as a structural function, is crucial in determining patient outcomes, and thus; should be paid attention to if the problem is to be dealt with. Long hours/shifts result in poor morale and judgment, hence; negative patient outcomes. In 2004, California became the first state to mandate staffing ratios to its nurses, specifically 4:1 where four patients could be handled by one nurse. Being one of the first American states to make history, California is keen on doing more for both the patients and nurses present in the healthcare system. After passing the mandated nurse ratios, California again tightened the ratios in 2008, allowing three areas to make changes to the nurse to patient ratios. The reason why this law came into effect was because of the surgical mortality and complications that came with high nurse to patient ratios. These mandated requirements were especially for areas that needed special attention, for example; acute care hospitals (Donaldson & Shapiro, 2010). According to C. Vincent in his book, Patient Safety, this law was seen as a means of improving on patient care delivery. However, according to the then vice president of external affairs for the California Hospital Association, the mandated policies have not solved the ongoing crisis that is making nurses leave or quit the nursing field to find other occupations. Jan Emerson further goes on to point out that the mandated nursing ratios have no proof of improving patient care. The National Nursing Shortage Reform and Patient Advocacy Act establishes that; depending on the acuity of patients, acute-care facilities must always provide nurses provided the nurse to patient ratios are met at all times. In this bill, registered nurses have the power to act in the interests of the patient, and they also have the right to be the patient’s advocate. According to Sloan and Chee-Ruey 2012, the Safe Nurse Staffing for Patient Safety and Quality Care Act establishes that nurses should care for patients by putting their safety first, which means that the nurse to patient ratios must be adhered to at all times in order to improve on a patient’s quality of care. This is especially helpful when hospital managers pressure nurses to care for more patients than is required. Patient safety should be the number one priority when it comes to hospitals and other healthcare facilities. However, this issue is not being given the attention it requires or deserves as profit is the most crucial thing for people in this field. Registered nurses make the highly needed quality difference when it comes to patient care, and when their number is insufficient, the care is greatly compromised and the risk of patient death/mortality is significantly increased. This is according to Aiken et al., 2008. In my opinion, this is just one factor in the nurse to patient ratio issue. For patients in acute-care, there is a need to have the number of nurses increased, or the number of patients per nurse revised. After California tightened their nurse to patient ratios, this numbers are revised meaning that each nurse has a reduced patient by one. Another major factor to consider is the satisfaction and retention levels of nurses in different healthcare facilities. When a nurse is assigned a smaller number of patients, he/she is in a better position to address each patient’s needs, thus; ensuring proper administration of medication and attention (Tevington, 2011). This would also mean that lunches or breaks cannot interrupt the provision of care for patients in a particular healthcare facility. Also, in order to be efficient, nurses must not have the emotional exhaustion that comes with catering to a higher number of patients as this leads to loss of nurses, and ultimately, patient dissatisfaction (Aiken et al., 2002). This emotional exhaustion is what may be referred to as burnout, where the nurses may feel drained after working long shifts without rest. After the introduction of the Affordable Care Act, primary health caregivers can now be tied to their healthcare facilities. This is in terms of incentives, reimbursement, and repayments depending on patient outcomes. The Centers for Medicare & Medicaid Services (CMS) are on the frontline in ensuring that every positive outcome in terms of patient satisfaction is met with some form of compensation, and this is working to ensure that all the key players are particularly incentivized to ensure quality care and safety to their patients. That being said, it is vital to note that nurses and primary caregivers are well-suited to protect their patients, hence; ensuring long-term improvement on the safety and quality of care provided to patients (Sasichay-Akkadechanunt, Scalzi & Jawad, 2003). In conclusion, it is better to try and salvage the situation before it gets out of hand. This is not possible if the ratio of nurse to patient is 1:8. Understaffing is a hindrance to the nursing profession because of its negative consequences to both the nurses and the patients they are meant to care for and serve. By having nationwide mandates on the nurses to patient ratios, it would be possible to improve the outcomes and improve the quality of care provided by all nurses (Kane et al., 2007). It would also give nurses the time and energy to educate and comfort, hence; reducing patient mortality that is currently being witnessed in most parts of the nation. References Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, L. T., & Cheney, T. (2008). Effects of hospital care environment on patient mortality and nurse outcomes. Journal of Nursing Administration, 38(5), 223-229. Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski J., & Silber, J. H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA, 288(16), 1987-1993. Donaldson, N., & Shapiro, S. (2010). Impact of California mandated acute care hospital nurse staffing ratios: A literature synthesis. Policy, Politics, & Nursing Practice, 11(3), 184-201. Kane, R. L., Shamliyan, T. A., Mueller, C., Duval, S., & Wilt, T. J. (2007). The Association of Registered Nurse Staffing Levels and Patient Outcomes: Systematic Review and Meta-Analysis. Journal of Medical Care, 45(12), 1195-1204. Sasichay-Akkadechanunt, T., Scalzi, C. C.,& Jawad, A. F. (2003). The relationship between staff nursing and patient outcomes. Journal of Nursing Administration, 33(9), 478-485. Sloan, F. A., & Chee-Ruey, H. (2012). Health economics. Oxford: Oxford University Press. Tevington, P. (2011). Professional issues: Mandatory nurse-patient ratios. MEDSURG Nursing, 20(5), 265-268. Vincent, C. (2011). Patient safety. New York: Macmillan Publishers. Read More