Introduction
There have been constant complaints from the nurses and health departments regarding the understaffing and overworking of nurses in hospitals. Researchers undertook to collect data to determine the minimum ratio of nurses to patients that would be adequate to increase their efficiency. Data were collected from staff in a variety of hospitals to determine whether an increase in nurses would have a positive impact on the health sector. The state of California was the first to implement legislation to regulate nurse-to-patient ratios in hospitals. A comparison of California with states that have not implemented such legislation would help conclude whether there is a need to enact such legislation. A comparison of the hospitals before and after the legislation would also help determine the effect of this regulation on staff ratios.
Discussion
Abood (2007) indicates that sending two emails to the respondents and then reminding them using a postcard, according to the Dillman method, led to a response rate of 35 percent. On the other hand, a response rate of 91 percent was realized after using short surveys in combination with phone call notifications and monetary motivation. The strategy used in the Abood (2007) article would be effective in ensuring cooperation from the legislator’s staff. The information has to be short and precise to ensure that the busy legislator will consider this analysis. It has to be clear about whom the information is to be delivered to. A shortened survey and telephone reminders will ensure that the legislator will go through the information and monetary incentives to the staff members to encourage them to allow entry. It will remind the legislator and his staff and avoid taking up too much of his time. Booking an appointment will ensure that the information is delivered at a convenient time.
- The researchers discovered that the numbers of registered nurses increased in the period between 1993 and 2001, which enabled the nurses to have more time for individual patients. This led to a decrease in the mortality rates (Kendall‐Gallagher, Aiken, Sloane, & Cimiotti, 2011).
- Mortality rates decreased the most in the hospitals that had the lowest nurse-to-patient ratios at first and then increased their staff in the period of 1993 to 2001 (Kendall‐Gallagher et al., 2011).
- The data showed that nurses in California have a lighter workload compared to nurses in New Jersey and Pennsylvania, which do not have the legislation that California adopted. An estimation of 88 percent of nurses in California has workloads that are compliant with the benchmark workload set by the legislation, compared to an estimation of 19 percent in New Jersey and thirty-three (33) percent in Pennsylvania (Aiken et al., 2010).
- A third of the nurses in California who gave feedback reported that the reduced workloads enabled them to provide better care for patients. It also provided better working conditions for them. The figure was higher than those that reported such feedback in Pennsylvania and New Jersey. The nurses in California were less likely to misdiagnose or fail to notice a change in patients’ health conditions (Donaldson & Shapiro, 2010).
- The nurses in California reported a decrease in the use of unlicensed nurses in the hospitals. They were replaced by an increase in the utilization of supplemental nurses or nurses who acted as agents (Twigg, Duffield, Bremner, Rapley, & Finn, 2011).
- There was also a decrease in the complaints from patients and the nurses. This affected the health sector positively because there were fewer nurses who would resign (Donaldson & Shapiro, 2010).
Conclusion
It is, therefore, safe to conclude that hospitals with staff ratios that are in line with the legislation set in California report higher levels of favorable outcomes. The legislation results in better quality health care and satisfied nurses. There are favorable working conditions, reduced patient complaints, reduced mortality rates, and increased attention of nurses to their patients.
References
Abood, S. (2007). Influencing health care in the legislative arena. Online Journal of Issues in Nursing, 12(1).
Aiken, L. H., Sloane, D. M., Cimiotti, J. P., Clarke, S. P., Flynn, L., Seago, J. A.,… & Smith, H. L. (2010). Implications of the California nurse staffing mandate for other states. Health services research, 45(4), 904-921.
Donaldson, N., & Shapiro, S. (2010). Impact of California mandated acute care hospital nurse staffing ratios: A literature synthesis. Policy, Politics, & Nursing Practice, 11(3), 184-201.
Kendall‐Gallagher, D., Aiken, L. H., Sloane, D. M., & Cimiotti, J. P. (2011). Nurse specialty certification, inpatient mortality, and failure to rescue. Journal of Nursing Scholarship, 43(2), 188-194.
Twigg, D., Duffield, C., Bremner, A., Rapley, P., & Finn, J. (2011). The impact of the nursing hours per patient day (NHPPD) staffing method on patient outcomes: a retrospective analysis of patient and staffing data. International Journal of Nursing Studies, 48(5), 540-548.