Department of Health Services Announces New Nurse-to-Patient Ratio Rules
The Department of Health Services yesterday announced new regulations that limit nurse-to-patient ratios in hospitals, the Los Angeles Times reports. Under the new rules -- the first such guidelines in the nation -- a nurse will not have to care for more than eight patients at a time. The rules also call for one nurse per five patients in medical-surgical units by 2005; about 50% of hospitals statewide currently meet that requirement, Gina Henning, a manager specialist with DHS, said (Hymon, Los Angeles Times, 7/2). The regulations call for one nurse per three patients in telemetry and step-down units by 2008. In addition, the new regulations state that licensed vocational nurses can comprise no more than 50% of the licensed nurses assigned to patient care and that only registered nurses can care for critical trauma patients. The rules also require at least one triage nurse in an emergency department to be a registered nurse (Silber, Contra Costa Times, 7/2). The rules, which are the result of a law signed by Gov. Gray Davis (D) in 1999, are intended to increase patient safety and "ease a grave nursing shortage" in the state by improving working conditions, Davis said, the Sacramento Bee reports (Rapaport, Sacramento Bee, 7/2). The rules are scheduled to go into effect Jan. 1, 2004, although many of the new ratios will not apply until 2008 to mitigate the financial burden on hospitals, the Los Angeles Times reports (Los Angeles Times, 7/2). DHS estimates that the new regulations will cost hospitals $422 million in 2004, $652 million in 2005 and more than $956 million in 2008, when all of the ratio requirements are implemented.
The new ratios will force hospitals to expedite nurse hiring to meet the requirements, the Fresno Bee reports (Fresno Bee, 7/2). However, opponents, including the California Healthcare Association, maintain that the rules will have "unintended consequences" and may force hospitals to close because they cannot hire enough nurses. In addition, patients may have to wait longer for emergency room care if hospitals are forced to limit admissions to meet the ratio requirements, according to CHA spokesperson Jan Emerson (Contra Costa Times, 7/2). The final regulations were shaped by public hearings and "intense lobbying" by hospital owners, who opposed the new rules as inflexible, and health care unions, who were divided over the details of the requirements, the San Francisco Chronicle reports (Russell, San Francisco Chronicle, 7/2). However, Henning said that the rules will let patients and families know that "nurses aren't overtaxed and that they aren't spread too thin to provide quality care" (Los Angeles Times, 7/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.