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A POLICY WHITE PAPER ON MANDATED NURSE PATIENT RATIOS
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A POLICY WHITE PAPER ON MANDATED NURSE PATIENT RATIOS
disadvantages and obstacles such policies provide as well as methods to implement
and manage such policies.
While the highest nurse to patient ratios are most often seen in long term care,
and rehabilitation facilities, it is reported that many nurses in acute care settings also
find themselves attempting to provide care to a number of patients which they deem
unsafe based on patient condition and acuity. Many of these nurses feel that due to
these ratios patient care, and thus, patient outcomes suffer. A study published in The
Journal of Professional Safety showed evidence in the reduction of falls, and inpatient
acquired conditions (such as pressure ulcers) by up to one third when staffing ratios
where determined by a nurse driven staffing committee rather than a board of directors
for the facility. (TS, 2015) In addition it was shown that nurses working in facilities with
higher nurse-patient ratios showed greater job satisfaction, less feelings of burnout, and
longer terms of employment allowing for a more experienced nursing staff. (ANA, 2016)
In contrast to the benefits of higher nurse-patient ratios some point out that the
additional cost on employers to staff at higher levels will ultimately be paid for by the
patients and their families, and have the most detrimental effects on those living in longterm care settings which have historically utilized a much lower staffing ratio. Although I
was unable to find any study which directly compared the cost of additional nursing staff
in relation to the costs saved in the prevention of falls, errors, infections etc, the
relationship seems to be implied. (Mark, 2013)
Another factor which should be considered in the implementation of mandated
staffing ratios is the availability of trained and educated registered and vocational
nurses to fill the required positions. Nationally many states are in high demand for such
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A POLICY WHITE PAPER ON MANDATED NURSE PATIENT RATIOS
staff and the demand is projected to grow. According to the Bureau of Labor Statistics
the current employment rate for registered nurses is expected to grow by 19% through
the year 2020. This growth does not account for the influx in required staffing which
would be needed should mandated or monitored staffing ratios be enforced. (BLS,
2016).
I would suggest the following steps be taken in order to solve the problem of
nurse-patient ratios
Federally mandated ratios for critical and acute care settings, with set
I believe that the need for mandated and monitored nurse-patient ratios is long
overdue and while many facilities already ensure safe and appropriate staffing ratios
the ability to abuse the ratios, and in-turn decrease patient care and outcomes exists.
There for it is my proposal that both state and federal agencies need step in and set
minimal guidelines to ensure that the safety and posterity of the population requiring this
facilities is taken care of appropriately.
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A POLICY WHITE PAPER ON MANDATED NURSE PATIENT RATIOS
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A POLICY WHITE PAPER ON MANDATED NURSE PATIENT RATIOS
References
TS. (2015). Higher nurse-to-patient ratios reduces injuries. The Journal of Professional
Safety, 60(7), 17-24.
Nurse Staffing. (n.d.). Retrieved April 11, 2016, from
http://www.ANA.org/MainMenuCategories/Policy-Advocacy/State/LegislativeAgenda-Reports/State-StaffingPlansRatios
Mark, B. A., Harless, D. W., Spetz, J., Reiter, K. L., & Pink, G. H. (2013). Californias
minimum nurse staffing legislation: results from a natural experiment. Health
Services Research, 48(16), 435-454.
Occupations with the largest projected number of job openings due to growth and
replacement needs, 2012 and projected 2022. (n.d.). Retrieved April 12, 2016,
from http://www.bls.gov/news.release/ecopro.t08.htm