2.50
Hdl Handle:
http://hdl.handle.net/10755/157351
Type:
Presentation
Title:
STAFFING PATTERNS BEFORE AND AFTER MANDATED NURSE-TO-PATIENT RATIOS
Abstract:
STAFFING PATTERNS BEFORE AND AFTER MANDATED NURSE-TO-PATIENT RATIOS
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Serratt, Teresa D., RN, PhD
P.I. Institution Name:The University of Nevada, Reno
Title:Assistant Professor
Contact Address:1664 N. Virginia St., Reno, NV, 89557-0134, USA
PURPOSES/AIMS:
This study identifies and describes changes in nurse and "non-nurse" staffing that may have occurred as a result of the enactment of nurse-to-patient ratios between 1999/2000 and 2005/2006 in California's acute care hospitals.
RATIONALE/CONCEPTUAL BASIS/BACKGROUND: Acute care hospitals have faced increased financial pressures from diminishing reimbursement, the proliferation of new medical technology and increased patient severity of illness that required a more skilled workforce. In response to these pressures, hospitals reduced nursing staff with expectations that labor costs would decrease and hospital financial performance would improve. However, reports of medical errors and poor patient outcomes brought this strategy under scrutiny and led to the establishment of mandated minimum nurse-to-patient ratios in California. This study is timely as few studies have been conducted after the implementation of the nurse-to-patient ratios in the state of California to examine the statewide changes in nurse and "non-nurse" staffing as a result of this legislation.
METHODS:
This study utilized a secondary analysis of OSHPD Annual Financial Report data with a pre-post design in which individual hospitals were observed at two time points (1999/2000 and 2005/2006). Descriptive analysis was conducted on all nurse and "non-nurse" staff. A matched paired t-test was performed for all nurse and "non-nurse" staffing categories to determine if there were statistically significant differences in mean productive hours per patient day or unit of service between the 1999/2000 and 2005/2006 values.
RESULTS:
The descriptive analysis of mean productive hours (MPHs) for nurse staffing indicated nearly an additional hour of medical/surgical registered nurse time per patient day from 1999/2000 (4.36) to 2005/2006 (5.16). Also, medical/surgical registry nurse time per patient day increased from 1999/2000 (0.30) to 2005/2006 (0.88) by more than one half hour. Little changed in the other medical/surgical nurse categories of LVN, nurse aid, and clerical/administrative staff. MPH for 'non-nurse' staffing indicated an increase in two staffing categories: diagnostic radiology (0.53 to 1.27) and respiratory therapy (0.35 to 0.83). The other categories (clinical laboratory, physical therapy, pharmacy, and total general services) showed little change in mean productive staffing hours (adjusted by patient days or service volume) from 1999/2000 to 2005/2006.
IMPLICATIONS:
These findings suggest most hospitals did make upward adjustments to RN staffing in response to mandated nurse-to-patient ratios by increasing use of regular employee RNs and registry nurses. However this adjustment did not decrease use of "non-nurse" staff who were not protected by the legislated nurse-to-patient ratios.
Mandated nurse-to-patient ratios may be a necessary step in creating an environment of quality patient care. Further research is needed to provide empirical evidence that these types of policies have the intended effect of improving healthcare in acute care hospitals.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleSTAFFING PATTERNS BEFORE AND AFTER MANDATED NURSE-TO-PATIENT RATIOSen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157351-
dc.description.abstract<table><tr><td colspan="2" class="item-title">STAFFING PATTERNS BEFORE AND AFTER MANDATED NURSE-TO-PATIENT RATIOS</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Serratt, Teresa D., RN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The University of Nevada, Reno</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1664 N. Virginia St., Reno, NV, 89557-0134, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">tserratt@unr.edu</td></tr><tr><td colspan="2" class="item-abstract">PURPOSES/AIMS: <br/>This study identifies and describes changes in nurse and &quot;non-nurse&quot; staffing that may have occurred as a result of the enactment of nurse-to-patient ratios between 1999/2000 and 2005/2006 in California's acute care hospitals. <br/>RATIONALE/CONCEPTUAL BASIS/BACKGROUND: Acute care hospitals have faced increased financial pressures from diminishing reimbursement, the proliferation of new medical technology and increased patient severity of illness that required a more skilled workforce. In response to these pressures, hospitals reduced nursing staff with expectations that labor costs would decrease and hospital financial performance would improve. However, reports of medical errors and poor patient outcomes brought this strategy under scrutiny and led to the establishment of mandated minimum nurse-to-patient ratios in California. This study is timely as few studies have been conducted after the implementation of the nurse-to-patient ratios in the state of California to examine the statewide changes in nurse and &quot;non-nurse&quot; staffing as a result of this legislation. <br/>METHODS: <br/>This study utilized a secondary analysis of OSHPD Annual Financial Report data with a pre-post design in which individual hospitals were observed at two time points (1999/2000 and 2005/2006). Descriptive analysis was conducted on all nurse and &quot;non-nurse&quot; staff. A matched paired t-test was performed for all nurse and &quot;non-nurse&quot; staffing categories to determine if there were statistically significant differences in mean productive hours per patient day or unit of service between the 1999/2000 and 2005/2006 values. <br/>RESULTS: <br/>The descriptive analysis of mean productive hours (MPHs) for nurse staffing indicated nearly an additional hour of medical/surgical registered nurse time per patient day from 1999/2000 (4.36) to 2005/2006 (5.16). Also, medical/surgical registry nurse time per patient day increased from 1999/2000 (0.30) to 2005/2006 (0.88) by more than one half hour. Little changed in the other medical/surgical nurse categories of LVN, nurse aid, and clerical/administrative staff. MPH for 'non-nurse' staffing indicated an increase in two staffing categories: diagnostic radiology (0.53 to 1.27) and respiratory therapy (0.35 to 0.83). The other categories (clinical laboratory, physical therapy, pharmacy, and total general services) showed little change in mean productive staffing hours (adjusted by patient days or service volume) from 1999/2000 to 2005/2006. <br/>IMPLICATIONS: <br/>These findings suggest most hospitals did make upward adjustments to RN staffing in response to mandated nurse-to-patient ratios by increasing use of regular employee RNs and registry nurses. However this adjustment did not decrease use of &quot;non-nurse&quot; staff who were not protected by the legislated nurse-to-patient ratios. <br/>Mandated nurse-to-patient ratios may be a necessary step in creating an environment of quality patient care. Further research is needed to provide empirical evidence that these types of policies have the intended effect of improving healthcare in acute care hospitals.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:47:40Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:47:40Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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