Our group identified nurse staffing to be a current issue in the healthcare field. A bill was recently reintroduced in congress addressing many of the issues our group wishes to look into.
The RN Safe Staffing Act (S. 58/ H.R. 876) focuses on many things, including “acuity of patients, level of experience of nursing staff, layout of the unit, and level of ancillary support.” All of these factors are essential to establishing a “right” nurse-patient ratio. This bill was sponsored by ANA and introduced to congress by Sen. Daniel Inouye (D-HI) and Reps. Lois Capps (D-CA) and Steven LaTourette (R-OH).
The RN Safe Staffing Act was originally introduced in 2003-2004 in order for hospitals to develop their own nurse staffing policies keeping in mind each unit’s unique characteristics. The bill was further refined for the upcoming session with several changes. These changes include holding Medicare-participating hospitals accountable for developing these unit-by-unit staffing policies and that the developing committees would be composed of at least 55% direct care nurses. Specific components of this bill were composed to ensure the staffing plans “are based upon patient numbers and the severity of the patients' health needs (acuity), take into account the level of education, training and experience of the RNs, take into account the availability of support staff, reflect staffing levels recommended by specialty nursing organizations, consider the physical layout of the unit and available technology, do not require RNs to work in units where they are not trained or experienced” (The RN Safe Staffing Act (S. 58/ H.R. 876)).
We know that safe staffing for nurses is an important issue to address because studies have shown that the consequences of not having adequate staffing are unsafe with multiple detrimental outcomes. One component of this is poor patient outcome. Common problems for patients related to ineffective nurse staffing include but are not limited to UTIs, upper GI bleeds, longer hospital stays, shock, failure to rescue, and mortality within 30 days of admissions. Studies have shown that insufficient nurse staffing is linked to poor patient outcomes and that adding RNs to unit staffing has been shown to eliminate almost 1/5 of hospital deaths. The satisfaction of nurses is also greatly affected by staffing issues. A poll of over ten thousand nurses conducted by the ANA in 2007 revealed that 73% of nurses don’t believe that staffing on their unit or shift is sufficient and 59.8% of the respondents knew of someone who left direct care nursing due to concerns about safe staffing. Poor staffing can cause nurse burn out, job dissatisfaction and turnover and poor patient outcome.
Group 10 Bloggers
We can see how this is a highly controversial topic, especially with the economy in the state it is currently in. It is very important to keep a small nurse to patient ratio and maintain adequate staffing for patient safety. It is also important to take into consideration the acuity of care the patients require and matching those patients with a competent nurse based on their level of education. While the bill addresses both of these aspects, does it take into consideration the budget cuts most hospitals are experiencing? We were wondering also if there was any talk of adding an amendment onto the bill to cover some of the additional costs necessary to maintain adequate staffing? Essentially, we are interested in how the bill, if made into a law, is going to be effectively enforced if some hospitals are incapable of paying the nurses required to meet the staffing ratios.
ReplyDeleteThis is clearly a very important piece of legislation. We were shocked when we saw that simply adding RNs decreased mortality by 1/5! That's incredible. Still, we want to know if there is any system in place or that may be proposed with the bill to accomplish these goals. It’s one thing to say that we’ll base staffing on patient acuity level and on RN skill level, but how will this be measured? It’s difficult to just assign a value to these statistics. In your research, have you come across any proposed systems that would uniformly and consistently define these statistics? We thought that there might already be some sort of staffing software in place in some facilities that might suit these needs, but we were unsure if this would be left up to each individual health institution or if such a system might be included as part of the legislation.
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We think that this is a very prevalent topic in today's nursing society. So often is nursing referred to the career that will always have vacancies but we feel like in the past year or so this has changed. As group 7 stated, the economy has made it hard to hire an adequate amount of nurses. However, it is always important to think of the patient first. We found it quite interesting the impact the number of nurses have on patient health. We think it is also important to utilize the education of each nurse. This is something that is commonly missed and could make each unit operate more efficiently!
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