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Nurse-to-Patient Ratios in Illinois
The Facts
For many years the ongoing nursing shortage has required nurses to work longer hours and care for more patients, causing many of them to make fatal and near-fatal mistakes on the job that could have otherwise been avoided. Illinois has attempted to remedy this situation by enacting The Nurse Staffing by Patient Acuity Law on August 24, 2007 ("The Nurse Staffing by Patient Acuity Law," 2012). Rather than setting hard numbers for specific nurse to patient ratios, the law instead requires hospitals to enact staffing plans recommended by a committee of their nurses that is comprised of at least 50% direct-care staff nurses. The plans created by these committees must be reevaluated semi-annually so that their effectiveness can be gauged. The nurses on staff are responsible for continually monitoring the plans that have been put in place to ensure that patient needs are properly met, as opposed to standard ratio laws that mandate a certain number of nurses to patients regardless of the circumstances ("The Nurse Staffing by Patient Acuity Law," 2012).
History
Due to financial concerns, many hospitals resist adding extra nurses to fully staff their floors, so it became imperative that legislators step in to force such action. The first state to successfully implement nurse to patient ratio staffing was California, which mandated that minimum nurse to patient ratios be maintained at all times ("Nursing Staff Plans and Ratios," 2011). This law was enacted in 2004 and since then many other states have followed suit with laws of their own, though...
Illinois believed that there was a better way to implement such a plan and still maintain the sought-after effects of California's bill. This was exemplified in the passage of the Patient Acuity Law, which allowed input from the medical profession, including the affected nurses, when attempting to create a plan for nursing coverage. This law has been in effect since its passage in 2007.
Effect of Legislation and Controversy Surrounding It
Studies have repeatedly found that nursing shortages often directly impact patient survival rates and infection rates, while nurse fatigue correlates to a higher incidence of self-reporting errors (Stone et al., 2007, p.571). In particular, when patient load is lower for nurses, there is a significant statistical gain associated with thirty day mortality and infection rates (Stone et al., 2007, p.575). Since the California nurse to patient ratio law has been implemented, studies have found that hospital nurses in that state cared for, on average, one less patient than nurses in other states, while medical and surgical nurses cared for two less patients than their counterparts in other states (Aiken et al., 2010, 904). These findings provide ample empirical evidence that limiting the number of patients…
References
Aiken, L.H., Sloane, D.M., Cimiotti, J.P., Clarke, S.P., Flynn, L., Seago, J.A., Spetz, J., & Smith, H.L. (2010). Implications of the California nursing staff mandate for other states.
Health Services Research, 45(4), 904-921.
Nurse staffing by patient acuity law. (2012). Retrieved September 16, 2012, from:
http://www.illinoisnurses.com/dotAsset/25925.pdf.
http://nursingworld.org/MainMenuCategories/Policy-Advocacy/State/Legislative-Agenda-Reports/State-StaffingPlansRatios.
http://c.ymcdn.com/sites/www.ionl.org/resource/resmgr/ratios.pdf.
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