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Quality

This bill required the California Department of health services to adopt stipulated regulations that established the minimum nurse to patient ratios in hospitals. This came as a response to the numerous concerns raised about patient safety as the dynamics of healthcare became more complex and hence resulting into a shortage of nurses in the late 1990s (Donaldson and Shapiro, 2010). The minimum staffing requirements set in place aimed to improve the quality of healthcare and patient safety as well as aiming to retain and acquire more nurses by improving the conditions of their working environment. As required by the law, the California Department of Health Services requires hospitals that provide acute care to maintain the minimum nurse to patient ratios. The stipulated ratios vary by unit ranging from 1:1 ratio in operating rooms, and 1:2 intensive care units, neonatal intensive units and critical care, as well as in post-anesthesia recovery and labor delivery. Further, the ratio is 1:4 in ante-partum and post-partum, emergency room and pediatric care and the emergency rooms. Its 1:6 on psychiatric units. In general, regular hospital units have a 1:5 ratio (Aiken et.al. 2010). In the subsequent years after the California law took effect, nurses became very optimistic about the stipulated ratios. According to the California Nurses Association, the ratio law has been a large success as demonstrated by a large increase in the number of registered nurses licensed in California. Moreover, there has been a reduction in the rate of nurse turnover as a result of better job satisfaction. In addition, it has been observed to improve patient safety and hence helped to save more lives and provided nurses with a platform to advocate for their patients (Cook et.al. 2012). However, in spite of these positive observations, hospitals are still not convinced especially in the absence of tangible evidence that the ratios set out actually improve the care provided by the nurses and reduce errors. A study conducted in 2002, two years before the law was implemented provided shocking findings. It showed that when a nurse is assigned four patients under his/her care, the risk of patient death rises by 7% for each additional patient assigned. The legislation which was signed into law in 1999 took effect on 1st January 2004 giving hospitals five years to implement the required changes. Contrary to the positive expectations after implementation, various problems that make the implementation process difficult to implement have been observed. A key limitation being that it requires continuous compliance with the ratio which means that the number of patients under the care of each nurse should not exceed the stipulated number at any one point in time during their shifts in any particular unit. So if a nurse has to use a restroom, then the law provides for him to reassign his/her patients to another nurse. Despite these minor setbacks in the implementation process, the requirements set out by the legislation have been observed to have a positive effect on the working environment of the nurses. This positive effect can be demonstrated by the increase in the ...Show more

Summary

Quality Nursing Name Institution Course Date Quality Nursing Over the years, the nursing profession in the United States has had numerous controversies as pertains what is the expected standard in the nature and type of work carried out by the nurses. This controversy has led to the formulation and implementation of various legislative rules that govern and protect the rights and duties of nurses, particularly on the working environment and the nurse-to-patient ratios…
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