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New York pushes nurse staffing ratios bill for hospitals, nursing homes

New York legislators are considering the Safe Staffing for Quality Care Act, a nurse staffing ratios bill for hospitals and nursing homes that is supported by the New York State Nurses Association and the New York State Public Employees Federation and opposed by the New York State Organization of Nurse Executives and the Greater New York Hospital Association. 

The bill (A00921 and S4553) would require one-nurse-to-one-patient staffing in the operating room, trauma emergency unit, intensive care and maternal/child care units during the second and third stages of labor. It would set a minimum of one nurse to two patients during the first stage of labor and in postanesthesia units; one nurse to three patients in antepartum, ED, pediatrics, telemetry and newborn and intermediate care nursery units; one nurse to four patients on med/surg units and acute care psychiatric units; one nurse to five patients on rehabilitation units; and one nurse to six patients on well-baby nursery units. The minimum requirements shall be adjusted to reflect the need for additional direct-care nurses in accordance with an approved acuity system.

The proposed ratios are more stringent for some units compared with California’s safe staffing ratios law, which went into effect in 2004 and mandates one nurse to two critical care patients, one nurse to four patients on telemetry units and EDs, and one nurse to five patients on med/surg floors.

California experience

Linda H. Aiken, RN, PhD, FAAN, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing in Philadelphia, and colleagues reported April 2010 in the journal Health Services Research that California hospital med/surg nurses cared for one fewer patient per shift, on average, than nurses in the other states studied. The lower rates were associated with lower mortality, and nurse outcomes were predictive of better nurse retention in California than in other states studied.

“It validates our experience in reducing harm and death,” said DeAnn McEwen, RN, MSN, president of the California Nurses Association/National Nurses Organizing Committee and vice president of National Nurses United in Oakland, Calif., which is supporting a national staffing ratios bill (H2187 and S992) pending in Congress.

Proposed staffing regulations

Bill A00921 and S4553 propose the following staffing ratios:

• OR — 1 nurse to 1 patient

• Trauma emergency — 1 nurse to 1 patient

• ICU — 1 nurse to 1 patient

• Maternal/child — 1 nurse to 1 patient (during second and third stages of labor)

• Maternal/child — 1 nurse to 2 patients (during first stage of labor)

• Postanesthesia — 1 nurse to 2 patients

• Antepartum — 1 nurse to 3 patients

• ED — 1 nurse to 3 patients

• Pediatrics — 1 nurse to 3 patients

• Telemetry — 1 nurse to 3 patients

• Newborn/intermediate care nursery — 1 nurse to 3 patients

• Med/surg — 1 nurse to 4 patients

• Acute care psychiatric — 1 nurse to 4 patients

• Rehabilitation — 1 nurse to 5 patients

• Well-baby nursery — 1 nurse to 6 patients

Note: The minimum requirements shall be adjusted to reflect the need for additional direct-care nurses in accordance with an approved acuity system.

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posted in: Career, news, Employer News, New York
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