California Hospitals Added RNs in Response to Nurse Staffing Law

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Since the implementation of a state law mandating nurse-patient ratios in California hospitals have hired more registered nurses and expanded access to nursing, according to a study published in the journal Health Affairs, reports the Sacramento Business Journal (Robertson, Sacramento Business Journal, 7 / 18).

For the study, researchers at the University of Pennsylvania and Arizona State University examined the hiring practices of a nurse from 1997 to 2008 (United Press International, 7 / 19).

Context

Former Governor Gray Davis (D) signed the measure nurse staffing (AB 394) in 1999, and the nurse-patient ratios were new implemented between 2004 and 2008 (Sacramento Business Journal, 7 / 18).

The legislation established several mandatory nurse-patient ratios for specific hospital units.For example, the law provides a nurse per patient in trauma units and one nurse for five patients in general medical-surgical (California Healthline, 3 / 3).

Matthew McHugh - principal investigator of the study and professor of nursing at the University of Pennsylvania - said California was the first state to enact legislation requiring the levels of nurse staffing (United Press International, 7 / 19 ).

Main results

The study found that California law nurse staffing resulted in an extra half hour of nursing care per patient day adjusted above what would have been expected without the law.

In hospitals in California, the amount of nursing care increased during the implementation of the law of the workforce, from 6.44 hours per patient day adjusted in 2004 to 7.11 hours per patient day adjusted in 2008.

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California Hospitals Added RNs in Response to Nurse Staffing Law
California Hospitals Added RNs in Response to Nurse Staffing Law

In California hospitals, the amount of nursing care provided increased during the implementation of the staffing law, from 6.44 hours per adjusted patient day in 2004 to 7.11 hours per adjusted patient day in 2008. In the control hospitals,



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That equals a rise from 6.44 hours per adjusted day in 2004 to 7.1 hours per adjusted day in 2008. For patients, that extra half hour of hands-on care from an RN makes a big difference. It's a significant amount more face time each day between patient



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Nursing Productivity or Nursing Utilization? « Clairvia | Care ...

Time "necessary" divided by the time "supplied" is really use: how many nurses have been "used". If the use was 90%, then it is assumed that patients do not really "need" all the time provided, and some have been wasted. 110% and if they do not have enough.

There is a critical link assumes that if patients are provided with the hours that we believe they need (use of 100%), positive results for patients (and the absence of bad things) happen. And, if the use is 90% what? Same results? And if the use is 115%, what? Same results?We do not really know.

To get to true productivity, we need a measure of output that speaks directly to patient outcomes. Something like, did patients with this DRG spend their stay on the intensive care unit as soon as certain benchmarks, and their clinical condition was the transfer of the ICU that we want it? What was their level of satisfaction? Did they go home with education allowing them to continue to recover? How much time between admission did it take to reach the acuity level "x". Or equivalent.

We're not there yet on these measures, but it is food for thought.

And we really appreciate the difference between the productivity of nursing and use of nursing.


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