Comparing California To The Other States For Nurses Ratio
The optimum nurse-to-patient ratio is a profound determinant of care quality, considering the benefits that emanate from proper staffing. According to Sharma & Rani (2020), enacting a standardized nurse-to-patient ratio results in multiple benefits, including improvement in patient care, patient satisfaction, reduction of medication errors, pressure ulcers, hospital-acquired infections (HAIs), lengthy hospitalization, and other adverse events like medication errors and falls. Despite the empirically justifiable associations between optimum nurse-to-patient ratio and improved care quality, all states except California are yet to pass and implement the comprehensive minimum nurse-patient ratios in hospitals.
It is essential to note that states face multiple challenges that compromise their ability to enact the policy for minimum nurse-to-patient ratios. Dierkes et al. (2022) contend that although California passed the bill that required medical-surgical floors to have at least 1 nurse for every 6 patients in 2004, the full compliance and implementation of this mandate cost each hospital about $700000 and $800000. In the same breath, Driscoll et al. (2020) argue that the notion of an optimal level of nurse staffing is ideally controversial due to the absence of a one-size-fits-all approach for assessing staffing levels. In this sense, hospital managers face challenges in harmonizing multiple factors that make up structural, process, and outcome domains. For example, healthcare organizations must understand the underlying determinants of proper staffing, including acuity and dependency levels, skill levels, numbers, and ward factors.
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Although optimum nurse-to-patient ratios result in positive care outcomes, it is valid to perceive policies for optimal nurse staffing as compliance and implementation, considering variations in resources and capacity across healthcare institutions. This factor explains why other states other than California are yet to pass and implement the optimum nurse-to-patient ratio regulation.
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References
Dierkes, A., Do, D., Morin, H., Rochman, M., Sloane, D., & McHugh, M. (2021). The impact of California’s staffing mandate and the economic recession on registered nurse staffing levels: A longitudinal analysis. Nursing Outlook, 219–227. https://doi.org/10.1016/j.outlook.2021.09.007
Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyombwe, T., & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing: Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, 17(1), 6–22. https://doi.org/10.1177/1474515117721561
Sharma, S., & Rani, R. (2020). Nurse-to-patient ratio and nurse staffing norms for hospitals in India: A critical analysis of national benchmarks. Journal of Family Medicine and Primary Care, 9(6), 2631–2637. https://doi.org/10.4103/jfmpc.jfmpc_248_20
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Compare California to other states for the nurse ratio
Amber Donnelly WALDEN INSTRUCTOR MANAGERPosted Date: September 1, 2022, 9:12 AMStatus: Published
Hi Raymond, great topic!! With the focus in nursing being on evidence-based research and making decisions based on evidence, why do you think that there has not been a nationwide change in staffing ratios if the evidence shows that there is an impact to patient care when the nurse to ratio is high? What do you think it will take for each state to make this change? Identify a state where nurse to patient ratio is being considered. Do you think they will have a successful argument and if so why?
Looking forward to your response, DR. D
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