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Senate bill would establish nurse staffing ratios

Saturday May 11, 2013
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U.S. Sen. Barbara Boxer, D-Calif., has introduced legislation that aims to improve patient care and address the nationwide shortage of nurses.

The National Nursing Shortage Reform and Patient Advocacy Act would protect the rights of nurses to advocate on behalf of their patients, establish minimum nurse-to-patient ratios in hospitals and invest in training and retention of nurses to address the nationwide nursing shortage, according to a news release from Boxer’s office.

The legislation builds on a California law that set minimum nurse-to-patient ratios, and extends those minimum standards to hospitals that participate in Medicare and Medicaid.

Specifically, the bill would establish minimum nurse-to-patient ratios that will "save lives, improve the quality of care and help to address the nursing shortage by creating a work environment that encourages nurses to remain in the hospital workforce," according to the news release.

For most hospitals, the bill calls for a direct care RN to be assigned to no more than:

• One patient in trauma emergency units;

• One patient in the OR, provided that a minimum of one additional person serves as a scrub assistant in the unit;

• Two patients in critical care units (including NICUs), labor and delivery units, coronary care units, acute respiratory care units, postanesthesia units and burn units;

• Three patients in EDs, stepdown units, pediatrics units, telemetry units, antepartum units and combined labor, delivery and postpartum units;

• Four patients in med/surg units, intermediate care nursery units, psychiatric units and other specialty care units;

• Five patients in rehabilitation units and skilled nursing units;

• Six patients in well-baby nursery units and postpartum units (three couplets).

The bill also provides whistleblower protections to support the right of nurses to advocate for the safety of patients and report violations of minimum standards of care; and invests in nursing mentorship demonstration programs to better prepare nurses for work in a hospital setting.

The bill has been assigned to the Health, Education, Labor and Pensions Committee, which will consider it before possibly sending it on to the whole Senate.

Boxer introduced a similar bill in 2011. That bill did not make it out of the committee.

Track the 2013 bill: www.govtrack.us/congress/bills/113/s739.


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