Nurse Staffing Standards for Patient Safety and Quality Care Act of 2019 requires hospitals to implement a stipulated nurse-patient ratio per unit and submit it to the Department of Health and Human Services (HHS). The bill also needs hospitals to follow the rules on how staffing ratios are determined. It also forbids hospital employees from performing duties meant for nurses only unless one has been authorized within the scope of practice rule.
Objectives of the bill:
- Set minimum patient-nurse ratio
- Study best practices for nursing
- Provide whistleblower protections to individuals who advocate for the rights of nurses
The population of aging people and chronically ill patients has increased rapidly due to improvements in medical technology globally. For this reason, there is a shortage of qualified nurses in hospitals at present. Job dissatisfaction, higher mortality rates, and turnout rates among nurses are high due to overworking, stress, and fatigue. This has led to a reduction in the quality of care according to patients. This bill aims at saving lives and improving patients’ health by ensuring that qualified nurses are adequate in the healthcare facilities.
Several studies have shown that a sufficient nurse-patient ratio is linked to a better workplace environment for nurses and exemplary care to patients. The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019 was formed as an act to support this evidence (Griffiths et al., 2020). This policy formulation aims to end dangerous staffing and ensure better patient safety and care quality is achieved in hospitals. In addition, it warrants the government to invest in nurses by creating conducive environments to support them in furthering their studies.
Key Regulatory and Legislative History
The policy was reintroduced by Schakowsky and Brown in Washington DC- (on May 9, 2017), it was co-sponsored by Kamala Harris (D-CA), Tammy Baldwin (D-WI), Elizabeth Warren (D-MA), Bernie Sanders (I-VT), and Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act. The Department of Health and Human Services (HHS) is responsible for ensuring that staffing plan in hospitals complies with the stipulated ratio per unit.
Timetable for actions
Implementation is expected to take two years after enactment in urban areas and four years in rural areas. The hospitals have to adjust based on nursing care plans, acuity, and patient safety. The ratio in the healthcare facilities per one nurse includes one patient in the trauma emergency unit and the operating room (GovTrack, 2021), 2 in intensive care, critical care, post-anesthesia, labor, and delivery. Three patients are allowed in antepartum, emergency, pediatrics, step-down, and telemetry units. The surgical or medical acute care, psychiatric care, and intermediate care nursery allow four patients per nurse, while rehabilitation units can have up to 5 patients.
Policy Actions and Alternatives
Some politicians are against the stipulated nurse-patient ratio because it increases hospital bills significantly and it overburdens the systems. Consequently leads to nursing shortage exacerbation and suffering of people in rural and critical hospitals. The Registered Nurse Safe Staffing Act (H.R. 2083/S.1132)) legislative is an alternative that can be used to provide quality care and patient protection (Olley et al., 2019). It states the safe nurse staffing levels at the healthcare facilities such as Medicare providers. However, it has no provisions for nurses to further their studies and become more skilled.
Griffiths, P., Saville, C., Ball, J., Jones, J., Pattison, N., Monks, T., & Safer Nursing Care Study Group (2020). Nursing workload, nurse staffing methodologies and tools: A systematic scoping review and discussion. International Journal of Nursing Studies.
Olley, R., Edwards, I., Avery, M., & Cooper, H. (2019). Systematic review of the evidence related to mandated nurse staffing ratios in acute hospitals. Australian Health Review, 43(3), 288-293.