The American Nurses Association favors proposed changes in Medicare and Medicaid rules for hospitals that would support the work of millions of RNs and APRNs, allowing them to provide more efficient and higher quality care to patients.
In comments submitted Dec. 16 to the Centers for Medicare & Medicaid Services, the ANA encouraged CMS to work with it in improving guidelines to ensure nurse staffing is adequate to provide high-quality care for Medicare and Medicaid patients. CMS had solicited comments on its proposed changes to the Medicare/Medicaid Conditions of Participation, the guidelines hospitals must follow to qualify for involvement and reimbursement in those programs.
The ANA's recommendations included implementation of hospital-wide staffing plans that identify an appropriate number of RNs on each unit to meet patients' needs; annual evaluation of staffing plans that analyze patient outcomes attributable to nursing care; and public posting of staffing plans.
The ANA also advocated revisions that would enhance the ability of APRNs, such as nurse practitioners and certified nurse-midwives, to secure hospital clinical and admitting privileges and membership on medical staff. Such status would allow APRNs to work to the full extent of their education, skills and licensure, and provide more comprehensive care to patients, according to the ANA. In the comments, the ANA urged consistent recognition of the increasing role of APRNs.
The ANA said its comments reflect changing trends in healthcare with the aim of taking full advantage of nurses' capabilities. The conditions also serve as guidelines for The Joint Commission and other private accrediting bodies that evaluate hospitals. CMS proposed modifications to the rules in October to reflect changes in current practice and an initiative by the Obama Administration to reduce regulatory burdens.
In comments submitted Dec. 16 to the Centers for Medicare & Medicaid Services, the ANA encouraged CMS to work with it in improving guidelines to ensure nurse staffing is adequate to provide high-quality care for Medicare and Medicaid patients. CMS had solicited comments on its proposed changes to the Medicare/Medicaid Conditions of Participation, the guidelines hospitals must follow to qualify for involvement and reimbursement in those programs.
The ANA's recommendations included implementation of hospital-wide staffing plans that identify an appropriate number of RNs on each unit to meet patients' needs; annual evaluation of staffing plans that analyze patient outcomes attributable to nursing care; and public posting of staffing plans.
The ANA also advocated revisions that would enhance the ability of APRNs, such as nurse practitioners and certified nurse-midwives, to secure hospital clinical and admitting privileges and membership on medical staff. Such status would allow APRNs to work to the full extent of their education, skills and licensure, and provide more comprehensive care to patients, according to the ANA. In the comments, the ANA urged consistent recognition of the increasing role of APRNs.
The ANA said its comments reflect changing trends in healthcare with the aim of taking full advantage of nurses' capabilities. The conditions also serve as guidelines for The Joint Commission and other private accrediting bodies that evaluate hospitals. CMS proposed modifications to the rules in October to reflect changes in current practice and an initiative by the Obama Administration to reduce regulatory burdens.
Other recommendations
In its comments, the ANA urged CMS to retain consistent reporting requirements for all deaths related to the use of patient restraints, including soft wrist restraints, to ensure the protections of patients' safety and rights. According to longstanding ANA policy, "only when there is no other viable option should restraints be employed."
The ANA also expressed support for the following CMS proposals that directly affect nursing practice and patient care for the roughly 60% of U.S. RNs who work in hospitals:
• Allowing the nursing care plan to be part of the interdisciplinary care plan.
• Expanding the use of standing orders and protocols for nurses to give medications.
• Permitting patients to take their own medications under certain circumstances.
• Deleting the requirement for verbal orders to be signed within 48 hours.
• Allowing flexibility for infection control programs, which nurses often lead.
To see the current CMS Conditions of Participation for hospitals, visit http://go.cms.gov/uKSLVy.
In its comments, the ANA urged CMS to retain consistent reporting requirements for all deaths related to the use of patient restraints, including soft wrist restraints, to ensure the protections of patients' safety and rights. According to longstanding ANA policy, "only when there is no other viable option should restraints be employed."
The ANA also expressed support for the following CMS proposals that directly affect nursing practice and patient care for the roughly 60% of U.S. RNs who work in hospitals:
• Allowing the nursing care plan to be part of the interdisciplinary care plan.
• Expanding the use of standing orders and protocols for nurses to give medications.
• Permitting patients to take their own medications under certain circumstances.
• Deleting the requirement for verbal orders to be signed within 48 hours.
• Allowing flexibility for infection control programs, which nurses often lead.
To see the current CMS Conditions of Participation for hospitals, visit http://go.cms.gov/uKSLVy.
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