Issue link: https://nnumagazine.uberflip.com/i/117852
other states without mandated staf���ng ratios. Despite initial concerns from opponents, the skill mix of nurses used by California hospitals has not declined since implementation of the mandated ratios. Not only did AHRQ deem the nurse-to-patient ratios a success, it is actively encouraging other states to follow California���s lead and adopt ratios. As part of its report on the ratios, AHRQ published a ���how to��� on establishing nurse-to-patient ratios, the key points of which are listed below. Getting Started with This Innovation ��� Leverage existing research: Signi���cant research exists on the negative impact of heavy nurse workloads on patient outcomes and on appropriate minimum staf���ng ratios. Those interested in enacting minimum staf���ng ratios can use this research to convince legislators of the merits of such mandates and/or to speed up the adoption process. ��� Secure buy-in by emphasizing bene���ts to patients and bottom line: Unless they buy in to the need for minimum ratios, hospitals will likely spend signi���cant time and money trying to ���ght them. Supporters can minimize their resistance by emphasizing the expected positive impact on patient outcomes (including lower patient mortality), costs (through reductions in adverse events and associated legal liability), nurse turnover, and hospital reputation. Sustaining This Innovation Push for legislation rather than other types of policies: Legislation mandating minimum staf���ng ratios is required to ensure long-term sustainability, since such legislation will be more dif���cult to modify than general hospital policies or professional association recommendations. Require ongoing reporting: Legislation alone does not ensure compliance over time. As a result, hospitals should be required to report staf���ng ratios on an ongoing basis so as to create accountability and allow for monitoring and oversight. Support nursing education: ���nancial support for education can help ensure a steady stream of new nurses into the workforce, which helps hospitals meet the staf���ng requirements. Nursing Advocacy: ���ghting the Good ���ght for Our Patients and Our Practice In California, the only state with a guaranteed RN-to-patient ratio law, the ratios have constantly come under attack. Just this year, the California Hospital Association and its partner, United Healthcare Workers West (SEIU-UHW), aggressively moved to dismantle the ratios.��They jointly proposed to ���suspend��� the ratios during RNs��� meal and break periods.�� This ���suspension��� would effectively destroy the ratios.�� California judge Gail Ohanesian ruled back in 2004 that eliminating ratios during meals and breaks would ���make the nurseto-patient ratios meaningless.�����This proposal is nothing more than a thinly veiled attempt to provide California���s hospital corporations with higher pro���ts���after raking in more than $20 billion in pro���ts between 2004 and 2010! Patient advocacy supporters of the ratios believe that nurses and patients everywhere should demand guaranteed ratios.�� RNs, community advocates, and good government groups strenuously oppose this assault on the ratios in California by the hospital industry and its union partner, SEIU-UHW. Their proposed language would be a major set back in the progress made in California as a result of the ���rst-in-the-nation nurse-to-patient ratios and, as Judge Ohanesian About National Nurses United National Nurses United (NNU) is the largest professional association and labor organization of direct-care registered nurses (RNs) in the United States. Our members represent direct-care RNs working in every state in the country, including advanced practice registered nurses (APRNs). Nearly 95 percent of our membership works in acute-care hospitals and/or critical access hospitals. Our mission is to provide safe, therapeutic, and effective care in the exclusive interests of our patients and to expand the voice of direct-care RNs and patients in the planning, development, implementation, and evaluation of public policy as it relates to the healthcare needs of our patients. NNU was founded in 2009, unifying three of the most active, progressive organizations in the United States and the major voices of 185,000 unionized nurses: the California Nurses Association/National Nurses Organizing Committee, United American Nurses, and Massachusetts Nurses Association. Combining the unparalleled record of accomplishments for nurses and patients embodied in the proud history of those nurses associations, which for some span more than 100 years, the establishment of NNU brought to life the dream of a powerful, national movement of direct-care RNs. At its founding convention in December 2009, NNU adopted a call for action premised on principles intended to counter the national assault by the healthcare industry on patient care conditions and standards for nurses, and to promote a uni���ed vision of collective action for nurses with campaigns to: ��� Advance the interests of direct-care nurses and patients across the U.S. ��� Organize all direct-care RNs ���into a single organization capable of exercising in���uence over the healthcare industry, governments, and employers.��� ��� Promote effective collective bargaining representation to all NNU af���liates to protect the economic and professional interests of all direct-care RNs. ��� Expand the voice of direct-care RNs and patients in public policy, including the enactment of safe nurse-to-patient ratios and patient advocacy rights in Congress and every state. ��� Win ���healthcare justice, accessible, quality healthcare for all, as a human right.��� 32 N AT I O N A L N U R S E W W W. N A T I O N A L N U R S E S U N I T E D . O R G NOVEMBER 2012