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References

Statistics

In a study done in 2002, it was reported that each patient added to nurses' workloads was associated with a 7 percent increase in mortality following common surgeries, and that nurse burnout and job dissatisfaction, precursors of voluntary turnover, also increased significantly as nurses' workloads increased (Aiken, Sloane, Cimiotti, Clarke, Flynn, Seago, Spetz, Smith, 2010)

Aiken, L. H., Sloane, D.M., Cimiotti, J.P., Clarke, S.P., Flynn, L., Seago, J.A., Spetz, J., & Smith, H.L. (2010). Implications of the California Nurse Staffing Mandate for Other States. Health Services Research. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908200/#b6

Shekelle, P.G., (2013). Nurse–patient ratios as a patient safety strategy, a systematic review. Annals of Internal Medicine, 158 (5 Pt 2), 404-9.

Welton, J. M. (2007). Mandatory Hospital Nurse to Patient Staffing Ratios: Time to Take a Different Approach. The Online Journal of Issues in Nursing, 12 (3). Retrieved from http://www.medscape.com/viewarticle/569391_3

Katelyn Tilley, RN

Statement of the Problem

Furture Concerns

  • Most states do not have a mandated law therefore hospitals are allowed to decide how many patients are allotted to one nurse in these states. It has been proposed in many states to be a legislative law but has only been passed in the state a few states.
  • This is important because increased nurse patient ratios lead to increase patient mortality/morbidity rates, medical errors and decrease nurse and patient satisfaction.When nurses have too many patients they are not able to provide the proper care necessary to ensure patient safety and patient satisfaction. Nurses are also more prone to burnout due to increase workload, therefore increasing the national problem on nursing shortage. If each state passed a law ensuring that nurses had the proper number of patients depending on their area of practice it would save lives, provide better patient care, and make for happier nurses.

In another study led by Aiken LH, an increase of one registered nurse per unit per day was related to a 9% reduction in the odds of death in the ICU, a 16% reduction in the surgical setting, and a 6% reduction in the medical setting (Shekelle, 2013). These studies also showed lower rates of such things as hospital-acquired pneumonia, unplanned extubation, failure to rescue, and bloodstream infections (Shekelle, 2013).

  • More nurses needed to meet the needs of the ratios.

  • Increased hired nurses= cut backs on other staffing to cut costs, such as certified nursing assistants, secretaries, and other assisting personnel.

  • Proof that it will be beneficial. In 2003, when California was researching to pass this law, it noted that "essentially there was not hard, scientific evidence in the literature indicating the number of patients nurses can safely and effectively handle while providing quality patient care” (Wisenberg Brin & Levins 2012).

Stakeholders

  • Nurses
  • Patients
  • Physicians
  • Hospitals/Healthcare Facilities
  • Government
  • State Legislative

Thank You!

Concepts for the Future

Policy Proposal

  • Pass laws requiring each state to set a maximum number of patients acceptable to one nurse in a particular area of practice
  • Create boards to ensure this is being followed
  • Research using evidence based practice as to whether this law is making a positive impact
  • Survey patients and nurses about their opinion on new laws passed

Target Population

Every state be required to pass a law that each individual nurse in each area of practice have a set amount of patients and it be illegal for healthcare facilities to give nurses more than the allotted amount of patients

If mandated nurse patient ratios became a policy for every state in the United States the target population would be nurses because it affects them directly. California is one of the states with a mandated nurse patient ratio law. In one survey done comparing California nurses with New Jersey and Pennsylvania nurses (states with no law in effect), it showed that a significantly lower proportion of California nurses experience high burnout: 29 percent, compared with 34 and 36 percent in New Jersey and Pennsylvania, respectively (Aiken, et. al, 2010).

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