Man­dated nurse ra­tios im­prove pa­tients’ health

Albany Times Union - Sunday - - PERSPECTIVE -

“State-man­dated nurse ra­tios would hurt pa­tient safety,” May 30, by Bea Grause, pres­i­dent, Health­care As­so­ci­a­tion of New York State, is based upon false as­sump­tions.

Hos­pi­tals rou­tinely un­der­staff nurses mak­ing con­di­tions un­safe for pa­tients. For years, regis­tered nurses have im­plored man­age­ment to do the right thing, but man­age­ment has largely turned a deaf ear.

Nurse-to-pa­tient ra­tios do not lead to “fewer physi­cians and other mem­bers of the care team,” as Grause ar­gues.

Hos­pi­tals do not use ev­i­dence-based sup­port for their ar­gu­ments against staffing ra­tios. The real facts are com­pelling. Hos­pi­tals with 1:8 nurse-to-pa­tient ra­tios ex­pe­ri­ence five ad­di­tional deaths per 1,000 pa­tients than those staffing with 1:4 ra­tios. The odds of pa­tient death in­crease by 7 per­cent for each ad­di­tional pa­tient the nurse must take on at one time. Both are from the Jour­nal of the Amer­i­can Med­i­cal As­so­ci­a­tion.

When RN staffing is in­creased by only 5 per­cent, in­fec­tions, pres­sure ul­cers and other prob­lems are re­duced by 15.8 per­cent, says Qual­ity Man­age­ment in Health Care. With­out ra­tios, hos­pi­tal stays are longer

and in­fec­tions and death rates higher.

In Cal­i­for­nia, where ra­tios have been in place for 15 years, health out­comes are su­pe­rior and there has been no net re­duc­tion in med­i­cal staffs. Hos­pi­tals saved money.

Grause says that New York’s non­profit hos­pi­tals have lim­ited re­sources. Not true. Hos­pi­tal rev­enues are vast, proven by the mul­ti­mil­lion-dol­lar salaries of top of­fi­cers.

Ra­tios are the way to get there: safe, qual­ity care; bet­ter scores; higher re­im­burse­ments; and equal­ity in pa­tient care at ev­ery hos­pi­tal in the state. Jill Furillo, rn Al­bany Ex­ec­u­tive Di­rec­tor, New York State Nurses As­so­ci­a­tion

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