The “Florida Hospital Patient Protection Act” s.395.104, F.S, relating to the delivery of nursing services with specific focus on staff planning. With a constant need for states authorities to boost the quality of care provided by health care facilities, there has been a need to understand the impact of nurse staffing and the nurse-patient ratio.
Purpose Statement
The purpose of this statement is to analyze the policy on patient protection through the delivery of nursing services. The paper will provide background information of the issue, explain what legal, regulatory and economic reason prompted the writing of the bill, identify all the stakeholders, analyze the health outcomes when the bill is implemented and conduct a SWOT analysis to determine the strengths, weaknesses, threats, and opportunities of the Act.
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Body
The main focus of the bill is Patient Protection through the delivery of quality nursing services. The act requires that health facilities implement staff planning for nurses through stating specific levels requirement, required ratios and particular dates, specifically orient nurses before assigning them, discourage imposition of mandatory overtime allowing nurses to operate under specific circumstances. All this is to boost both patients and nurses safety. In past years, Florida has experienced a shortage of nurses which forced the existing nurses to care for a large number of patients at the same time. The results of this were inferior care as well as nurse burnout. The Florida Center for Nursing predicted that by 2025, the state will face a nursing shortage of over 50,000. To address the lack of nurses, Florida has actively kept the education and advancement of nurses as a top priority. The state identifies that there is an association between high levels of experienced RN staffing and lower rates of adverse patient outcomes. According to Mensik (2014), each additional patient assigned to a nurse has a 7% likelihood of dying within 30 days of admission and a 7% increase in failure to rescue. For this reason, federal regulation has been put in place to ensure that health facilities have an adequate number of licensed and experienced RM’s as well as practical nurses to provide quality care to all patients
Stakeholders comprise of all the entities that are integrally involved in a function and are substantially affected in the case of any changes. Direct stakeholders involve anyone who has a visible role in a firm, regulation or operation. On the other hand, indirect stakeholders include anyone else whose interest is either enhanced or threatened by the activities of a business or changes in reforms. The different stakeholders of this policy include health care facilities, nurses, patients, and the government. The federal government is very active in the regulation of the health care industry. Through the passing and implementation of bills, the federal government shows its support for the provision of health care and patient protection. In this case, the government understands the importance of nurse staffing in the reduction of medical errors, more extended hospital stays, mortality rates, and underperforming staff.
Nurses play an essential role in ensuring patient safety; the staff-mandated staffing rations are crucial to not only ensure the safety of patients but also of nurses. Nurses, in this case, are the main providers of care to patients, the quality of care is influenced by the systems the muses work in, which include the staffing levels, climate, and culture of working environment and the support services. Health care facilities include hospitals, clinics, health centers, nursing homes. It is the function of the healthcare facilities to dispense services and resources for better health. Since healthcare facilities operate in the context of the socio-economic and political framework of the country, they are direct stakeholders in this case. The bill requires that healthcare facilities implement a nursing staff plan through their administrators, discourage use of video cameras as a substitute for the necessary level of care and annually review their nursing staffing levels. They are, therefore, in the front line when it comes to ensuring patient and nurses’ safety. Patients play an important role in the healthcare industry, being the ones receiving care, they are profoundly affected by the conditions surrounding healthcare facilities. The bill is focused on protection of patients through the implementation of different strategies to assist in improving the quality of care. They are at the center of the policy.
High nurse staffing levels combined with a richer skill mix have been closely associated with improved patient outcomes (Twigg, Geelhoed, Bremner, & Duffield, 2013) . Improved staffing levels have also been associated with economic benefits. Having a sufficient number of RN’s who are experienced, prevent adverse effects in patients, therefore, preventing them from staying longer than necessary in the hospital. This not only results in quality patient care but economically it leads to cost containment. Regulations are essential in the shaping of the welfare of the economy and society as a whole. Regulatory policies work in favor of the public interest and in this case, ensuring appropriate staffing levels for nurses is a means to not only boost their safety but also encourage the provision of quality care which leads to reduced adverse effects and prevention of longer stays. Federal states and laws high impact on how nursing is performed. Legal concerns can shape the environment in which nursing is practiced. The care provided by nurses as well as the nurses themselves is judged based on a legal definition of the standard of care for nurses. It is this economical, regulation and legal factors that prompted the writing of the bill.
Safe staffing mainly leads to positive health outcomes; it is key to quality care, reduction of mortality, nurse retention, and increased savings (Alligood, 2016) . At local levels, most hospitals that fail to implement safe staffing end up additional costs due to the high rate of turnover and face high patient mortality. Generally, state authorities that execute nursing levels have a high safety outcome for both patients and nurses, reduced patients care cost (Alligood, 2016). T herefore, this ensures a good quality of life for their citizens which automatically increases the state’s GDP as well as an extension of life expectancy for their population. Having passed a bill that supports specific nurse-patient ratio, California has experienced significant lower job-related injuries and illnesses for its nurses as well as improved patient outcomes. The bill will put Florida on the map internationally in states that provide quality care for patients and ensures safety for its nurses.
A transformed healthcare system is essential to ensure that patients receive the quality care that they deserve at all times. APRN’s have a crucial role to play in transforming the health system to create a more accessible, high-quality and value-driven environment for their patients (Institute of Medicine, 2011) . The skills essential for leadership include collaboration, communication, negotiation, delegation, and coordination. An APRN can provide transformational leadership by effectively implementing patient safety as well as initiatives that relate to quality improvement within the context of the inter-professional team through effective communication. Also, transformational leadership can be provided through participation in the design and implementation of new models that support the care of delivery and coordination.
SWOT Analysis
Strengths
Improved quality of Care
Reduced mortality rate
Improved safety of nurses and patients
Reduced patient stay in the hospital
Nurse retention
Weakness
Reduced scheduling and staffing flexibility
Increased costs
Opportunities
Better patient experience
Better nurse retention rates
Advanced nurse education and training
More job opportunities for nurses
Threats
Increased payroll spending
Lower staff income
Lack of resources to achieve output
Conclusion
In 2004, California became the first state to implement nurse-to-patient staffing ratios (DPE, 2011) . Hence, the state has since then experienced increased quality of care as well as safety for its patients and nurses. Nurse staffing laws are implemented to protect both the patients and the nurses. Therefore, the implementation of this law will help to reduce the mortality rate, increase nurse retention, reduce prolonged stays in the hospital and generally improve the quality of healthcare. Policy analysis of the Florida Hospital, Patient Protection Act, reveals that the bill will generate numerous positive outcomes for the state’s healthcare system. It is necessary for the lawmakers in different countries to identify the need for improving staffing levels for nurses and the impact it has on the delivery of quality care.
References
Alligood, M. (2016). Minimum Nurse-Patient Ratios. AJN, American Journal of Nursing , 116 (9), 13. doi:10.1097/01.naj.0000494673.70100.aa
DPE. (2011). Impact of Nurse-to-Patient Ratios: Implications of the California Nurse Staffing Mandate for Other States. Retrieved April 13, 2019, from https://dpeaflcio.org/programs-publications/issue-fact-sheets/impact-of-nurse-to-patient-ratios-implications-of-the-california-nurse-staffing-mandate-for-other-states/
Institute of Medicine. (2011). Transforming Practise. In The Future of Nursing: Leading Change, Advancing Health (p. 85). Washington, DC: National Academies Press.
Mensik, J. (2014). What every nurse should know about staffing. American Nurse Today , 9 (2). Retrieved from https://www.americannursetoday.com/what-every-nurse-should-know-about-staffing/
Twigg, D. E., Geelhoed, E. A., Bremner, A. P., & M. Duffield, C. (2013). The economic benefits of increased levels of nursing care in the hospital setting. Journal of Advanced Nursing , 69 (10), 2253-2261. doi:10.1111/jan.12109
