NR 451 Healthcare Policy Assignment Week 3

NR 451 Healthcare Policy Assignment Week 3 Healthcare Policy Assignment Health Bill H.R. 2581: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019 ► Presented in this bill are ratios of safe care to be established that “provides adequate, appropriate, and quality delivery of health care services and protects patient safety; and is consistent with the requirements of this title”. These ratios include: ► 1:1 trauma emergency units. ► 1:1 operating room units, provided that a minimum of 1 additional person serves as a scrub assistant in such unit. ► 1:2 critical care units. ► 1:3 emergency room units, pediatrics units, stepdown units, telemetry units, antepartum units, and combined labor, deliver, and postpartum units. ► 1:4 medical-surgical units, intermediate care nursery units, acute care psychiatric units, and other specialty care units. ► 1:5 rehabilitation units and skilled nursing units. ► 1:6 postpartum units and well-baby nursery units. ► Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019 (H.R. 2581). (n.d.). Retrieved from Health Bill H.R. 2581: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019 ► The purpose of this bill takes a vested intrest in promoting quality care through improvements to the delivery in which health care services are provided to patient in health care facilities ► Dur to inadequate registered nurse staffing practices that are often poorly monitored results often in a disconnect in the delivery and quality of health care services provided to patients ► After thorough and numeous studies completed it has been found that patient outcomes directly correlate to the direct care registered nursing staffing levels. With implementation of staffing ratios showing improved patient outcomes in addition to higher nurse retention rates, in additon to reduced lengths of stay for patient admissions. ► Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019 (H.R. 2581). (n.d.). Retrieved from Bill Summary ► Patient assignments are included in the calculation of the direct care registered nurse-to-patient ratio. ► Nurses assigned to any unit with the hospital must have unit-specific competence, having received oreination to that specific unti and provide competent care to the patients on that unit. ► “Each patient shall be assigned to a direct care registered nurse who shall directly provide the assessment, planning, supervision, implementation, and evaluation of the nursing care provided to the patient at least every shift and has the responsibility for the provision of care to a particular patient within his or her scope of practice”. ► Registered nurse administrators, supervisors, managers, charge nurse, case manager, or any other hospital administrator or supervisor, are not to be included in the calculation of the direct care registered nurse-to-patient unless they have a direct care assignement. ► Additional personnel may perform patient care tasks in accordance with scope of practice laws and regulations. ► Temporary nursing agency staff shall not be assigned assignment to which competence has not been demonstrated and orientation was received. ► Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019 (H.R. 2581). (n.d.). Retrieved from Impact Professional Nursing Practice Standard if passed o PASSING OF THIS BILL WOULD ENSURE ADEQUATE STAFFING TO WHICH THE REGISTERED NURSE MAY PERFORM THE DUTIES REQUIRED TO PROVIDE QUALITY CARE TO PATIENTS UNDER THEIR CARE LEADING TO BETTER AND MORE SUSTAINED PATIENT OUTCOMES. o STAFFING AND TEAMWORK ON A UNIT CAN INDIRECLTY INFLUENCE THE QUALITY OF CARE PROVIDED (NEVES, PARRERIA, GRAVETO, ET AL, 2020). OPTIMIZING SAFETY AND QUALTIY OF CARE PROVIDED IS DEPENDENT ON ADEQUATE NURSE STAFFING RATIOS AS WELL AS COMPETENCIES IN PRACTICE (NEVES, PARRERIA, GRAVETO, ET AL, 2020). o THE HIGHLY COMPLEX AND UNPREDICTABLE NATURE OF HEALTH CARE REQUIRE ADEQUATE LEVELS OF QUALITY AND SAFETY THROUGH WHICH IMPLEMENTED STAFFING RATIOS CAN IMPROVE THE QUALITY AND SAFETY OF CARE PROVIDED (NEVES, PARRERIA, GRAVETO, ET AL, 2020). Impact on Professional Nursing Practice Standard if not passed ► If H.R. 2581 is not passed, the ability of nurses to provide quality and safe care may continue to diminish due to high nurse-to-patient care resulting in a negative impact on patient care. This furthermore can lead to increased instances of missed care, extended patient stay, decreased nursing competiences, and decreased retention of nursing staff leading to further nursing shortage. ► “The severe consequences of missed care, that is mortality, and the correlation between in‐hospital mortality, nursing education and nursing–patient ratio, which are indicators of care quality, are arguments for maintaining adequate staffing levels to avoid missed care” (Wieczorek‐Wójcik, Krzemińska, Owczarek, & Kilańska, 2020). Implications for Nursing Practice ► Currently I am employed as an outpatient dialysis nurse. In our practice the ratio for direct patient assignments is 1:15. At times this assignment can be larger, with up to 30 patients. Our patient population ranges in acuity level from low to high. This results in some patient assignments becoming more difficult than others in an already fast-paced demanding position. ► With passing of this bill, the decrease in nurse-to-patient ratios would result in a more focused approach to each patient resulting in better patient outcomes and a more idividulized care process. Due to the nature of ESRD and dialysis needs there are a great deal of other comorbidties invovled in patient care requiring an increased need for nurse education, intervention, and care to fully encompass patient needs. ► If this bill fails to pass, there could be possible increased readmission to hospitals for the ESRD patient, increased turnover in nursing staff due to demanding patient assignemnts, a decrease in the education process for each patient, and a possible decrease in the care provided. Community Impact ► Implementation of H.R. 2581 can positively impact the community. ► There will be an increase of quality and safety of care provided to patients as a result of the nurse maintaining a manageable patient work assignment. ► Better education and care of patients hospitalized can lead to decreased readmission rates and an increase in the quality of care provided. ► A decrease in missed care can lead to better patient outcomes through increased competency levels through orientation of registered nurse in assigned assignemnts. ► An increase in retention of nursing staff leads to a more competent and stable staffing situation leading to better patient outcomes. Communication Strategies ► To communicate with legislators in favor of the proposed bill, it is important to know the representatives in the are and wether they accept or oppose the proposed bill. ► Through further research, the state of North Carolina does not curretnly have any sponsors or opposittion to this bill. ► Through contact with representatives involved in healthcare policies, involvement in professional nursing organizations, and increased involvement in knowledge of healthcare policies and participation in legislative processes nurses can advocate for needed change in current polices in favor of best practice. References  Neves, T. M., Parreira, P. M., Graveto, J. M., Maria João Baptista Dos Santos De Freitas, & Rodrigues, V. J. (2020). Nurse managers' perceptions of nurse staffing and nursing care quality: A cross‐sectional study. Journal of Nursing Management, 28(3), 625-633. doi:10.1111/jonm.12966 Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2019 (H.R. 2581). (n.d.). Retrieved from Wieczorek‐Wójcik, B., Krzemińska, A. G., Owczarek, A. J., & Kilańska, D. (2020). The in‐hospital mortality as the side effect of missing care. Journal of Nursing Management. doi:10.1111/jonm.12965