Are you aware of the safe staffing ratios required by your state, and the benefits of meeting them? If so, does your facility have a strategy in place to ensure that you have the recommended number of registered nurses on staff?
These are essential questions for healthcare facilities, and with good reason. Not only because failing to comply with safe staffing ratios can incur state-mandated penalties, but also because those ratios are in place to ensure the best possible outcomes, and can offer your facility substantial cost savings, too.
The Benefits of Meeting Safe Staffing Ratios
“Identifying and maintaining the appropriate number and mix of nursing staff is critical to the delivery of quality patient care,” the American Nurses Association (ANA) explains in NursingWorld. “Numerous studies reveal an association between higher levels of experienced RN staffing and lower rates of adverse patient outcomes.”
That’s a powerful fact, and one that Oregon Senator Jeff Merkley echoed when introducing his Safe Staffing for Nurse and Patient Safety Act of 2018. An attempt to resolve vagueness with existing federal recommendations and create across-the-board safe staffing ratios for all states, the legislation directly attributed a decrease in wasted resources and an increase in patient safety to “proper” ratios.
“The overwhelming weight of academic research continues to demonstrate patient that safety, prevention of medication errors, failure to rescue situations, patient deterioration, patient death, and nurse burnout are all proportionate to the number of nurses staffed in a hospital,” as Sen. Merkley explains in the bill.
An appropriate nurse-to-patient ratio, he adds, “decreases the rate of patients’ hospital readmissions.” Because readmissions within 30 days of initial discharge “cost Medicare an estimated $26 billion per year,” maintaining optimal ratios not only “reduces such readmissions” but also “pays for itself over the long term.”
On top of that, these ratios help create a better workplace for nurses, in a field that’s particularly prone to burnout. In an overview of the benefits of safe staffing ratios, Nurse.org points to a 2014 study by the Robert Wood Johnson Foundation showing that “almost one out of five new nurses leaves the profession within the first year of gaining licensure” because of burnout and understaffing.
“Short-staffed and overworked nurses pose real risks to patient safety, health outcomes and workforce retention in hospitals,” writes Tony Abraham at Healthcare Dive, adding that “burnout-related turnover rates among nurses [are] already costing U.S. hospitals an estimated $9 billion per year.”
The Future of Safe Staffing Ratios in the U.S.A.
Though it ultimately failed to pass into law, the Safe Staffing for Nurse and Patient Safety Act has been held up as a model for a nationwide ratio. In its endorsement of the Act, the ANA announced that it “not only considers the complexity and stability of patients, but also nurse experience, available technology, resources and unit workflow such as numbers of admission, discharges and transfers.”
True, the ANA can be expected to endorse legislation that would increase employment of nurses. But, as the Association points out, its approval also comes from the approach of the legislation, which determines safe staffing ratios specific to each unit within a hospital as determined by committees “comprised of at least 55 percent direct care nurses.”
If enacted on a nationwide level, this approach, per the ANA and other nursing advocacy groups, “will benefit patients, registered nurses (RNs) and hospitals by decreasing adverse health events, nurse turnover, and costly hospital readmissions.”
Just as importantly, a federal law would also bring consistency to nurse ratio efforts across the nation. Though there is a federal regulation affecting nurse staffing ratios, it only requires hospitals that participate in Medicare to have “adequate numbers” of RNs. The vagueness of that language leaves it difficult to determine just what the federal nurse-to-patent is meant to be.
It’s up to states, then, to pick up the slack and create laws or regulations mandating safe staffing ratios. As of 2019, though, just 14 states had done so. And only seven of them used the committee model favored by the ANA (for the record, those states are Connecticut, Illinois, Nevada, Ohio, Oregon, Texas, and Washington.)
- Pro Tip: It’s important to note that even states without formal laws or regulations on the books offer recommendations for safe staffing ratios. Modern Healthcare has a handy infographic with details for each state; you can find it here.
Need Help Meeting Safe Staffing Ratios?
The onus is on hospitals, then, to determine whether they’re meeting the safe staffing ratios of the state in which they operate — or to determine their own ratios in the absence of any specific legal guidelines. Those who prefer limited government involvement may prefer the latter. But they should also be aware that extra vigilance is required to achieve a ratio that benefits their facility, nurses and patients.
To do so, the ANA offers some helpful guidelines, including the consideration of number of admissions and discharges, patient complexity, physical layout of the nursing unit, and more. (Learn more with the ANA’s 7 Core Components of Nurse Staffing document.)
It’s also worth considering getting the help of a proven healthcare workforce specialist to meet your safe staffing ratios. Staffing providers like CareerStaff can draw upon a nationwide network of nurses to help ensure you have the RNs you need to ensure optimum patient care. To learn more, contact us here, email us at firstname.lastname@example.org, or call us at 972-812-3200. You can also submit a nurse staffing request here.