Module 4 Assignment PDF

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module 4 assignment for the influence of policy, finance, and law on healthcare...

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Module 4: Policy Briefing

Nicole Visneski NUR4327: Influence of Policy, Finance, and Law in Healthcare Kristy Gerster Rasmussen University August 1st, 2021

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Summary In 1999, California became the first state to establish minimum RN-to-patient ratios for hospitals. The Assembly Bill 394 was signed into law, which established a specific number of nurse-to-patient for acute care, acute psychiatric, and specialty hospitals in California. The final regulations to implement the law were issued in 2003. January 1st, 2004 the hospitals were required to meet the ratios (Kasprak, 2019). The bill was created after concerns of patient safety and the complexity of care with patients. Staffing ratios are designed to improve patient mortality and nurse retention (Kasprak, 2019). Process of Legislation In took almost a decade to pass safe staffing ratios in California, with the help of Associations and its members it was done. Nurse ratios were introduced back during the AIDS epidemic at San Francisco’s General Hospital. The nurses demanded nurse-to-patient ratios in their contract on the AID wards (National Nurses United, n.d.). Over the years after that nurses began to adopt the same approach (Press, 2021). In 1992-93, the California Nurses Association (CNA) cosponsored Assembly Bill 1445 legislative session, but the bill did not make it out of committee. In 1997–98, the CNA cosponsored a safe-staffing bill Assembly Bill 695 and it was approved by the state legislature, but vetoed by the then-governor Pete Wilson (Press, 2021). After this the CNA and thousands of nurses rallied in favor of the bill at the states’ capital and the governor’s office. They won and then-governor Davis signed the legislation on October 10th, 1999 (Press, 2021). In 1999, then-governor Gray Davis signed Assembly Bill 394 into law. It directed that state’s health department to come up with nurse-to-patient ratios. To help develop ratios, the DHS conducted a study by researchers at the University of California. The DHS

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received recommendations from California Hospital Association (CHA) and the CNA. The DHS decided on 1:6 ratios in med-surg in 2004 then 1:5 in med-surg in 2005 (Mason et al., 2016). Outcomes of Legislation Hospitals in California that were required to follow the safe staffing ratios have shown to have save lives and enhance patient care. Research has shown that safe staffing levels and ratios help improve patients’ outcomes in mortality, adverse events, complications, failure to rescue, quality of care, costs, and length of stay (National Nurses United, n.d.). A study was shown that if New Jersey and Pennsylvania matched California’s ratios then they would have fewer deaths in med-surg. The study showed New Jersey would have a 13.9% decrease and Pennsylvania would have a 10.6% decrease (National Nurses United, n.d.). The California staffing ratio law also improved nurses’ health and safety. The Assembly Bill 394 has helped nurses as well by lowering occupational injury and illness rates by 30 percent and reducing self-porting job dissatisfaction (Press, 2021). Improved nurse working environment turns into saved lives, saved money, and better safety. Recommendation The nursing leader should support working with other nurse leaders on similar legislation. Mandating safe staffing ratios improves patient and nursing outcomes. These benefits include lower mortality rates, lower cost, improved quality of care, decreased nurse burnout, prevent adverse events, and improved patient satisfaction. Some recommendations could include incentives to nurses that get involved politically. This could include paid time, free meals/gift cards, or nursing attire. Incentives push employees to do things they would not normally do. By

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getting more nurses involved politically, the more voices that will be heard. The CNA and thousands of nurses lobbying is what got Assembly Bills to get placed into law. Pros/Cons To any recommendation there are pros and cons that factored into the decision. Pros to offering incentives are that more nurses are getting involved politically. This is directed to new/younger nurses that are going to be around for the next generation. They need to see that getting involved and their voices heard is important to their career. Another pro is that the nurses are getting rewarded for doing good. The job as a nurse is stressful so sometimes getting little incentives can brighten a day and maybe improve nurse satisfaction. With any pro there will cons, one could be that the incentives could be taken advantage of. There is always a bad apple in the bunch and easily a nurse could lie about being politically involved. Another con could be that the hospital does not want nurses to get involved in certain policies. If a nurse is getting incentive to get involved politically means that they can have their own opinions. This could backfire on the hospital itself and cause internal problems with employees.

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References Kasprak, J. (2019). California RN Staffing Ratio Law. Ct.gov. https://www.cga.ct.gov/2004/rpt/2004-R-0212.htm Mason, D. J., Gardner, D. B., Freida Hopkins Outlaw, & O’grady, E. T. (2016). Policy & politics in nursing and health care (7th ed.). Elsevier. National Nurses United. (n.d.). RN Staffing Ratios: A Necessary Solution to the Patient Safety Crisis in U.S. Hospitals. https://www.nationalnursesunited.org/sites/default/files/nnu/graphics/documents/RatiosANecessarySolutiontothePatientSafetyCrisisinUSHospitals.pdf

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