Thursday, October 30, 2008
Political Action
Over the past weeks, each member of the group contacted 2-3 key informants whom we felt would benefit and appreciate reading our blog. As one can see, many new people visited the blog while others contacted the authors via email to field questions and make comments. Each question or concern was responded to by a member of the group. We hope to see this bill move through the Virginia House of Representatives and we, as a group, will continue to monitor the bill's status. Keeping up with responses is another important tool and as a group we will continue to reply to any comments or questions posted on our blog.
Tuesday, October 14, 2008
Where we stand
We support House Bill 1046 and its proposition to increase nursing staffing regulations in nursing homes. Our opinion is supported by scholarly evidence, patrons: Watts and Plum, and Senators: Petersen and Whipple.
The first step of our political action plan was creating this Blog in order to bring awareness about House Bill 1046. Information presented on the Blog include current laws regarding staffing requirements in nursing homes and how the changes proposed in this bill can enhance the care given to the residents of these facilities. Our next step includes contacting key stake holders and legislators to invite them to explore the Blog, and to identify reasons why we believe this bill should be passed. Our ultimate goal is that in promoting this Blog and educating the public and stake holders, House Bill 1046 will be passed and quality of care in nursing homes will be improved.
The first step of our political action plan was creating this Blog in order to bring awareness about House Bill 1046. Information presented on the Blog include current laws regarding staffing requirements in nursing homes and how the changes proposed in this bill can enhance the care given to the residents of these facilities. Our next step includes contacting key stake holders and legislators to invite them to explore the Blog, and to identify reasons why we believe this bill should be passed. Our ultimate goal is that in promoting this Blog and educating the public and stake holders, House Bill 1046 will be passed and quality of care in nursing homes will be improved.
Governmental objective, political influences and impact of policy change
Governmental Objectives
Staffing regulations vary from state to state. For example, California requires each facility to have 3.2 nursing hours per patient day, whereas Maryland requires a minimal total of 2 hours of direct patient care per day.
There is a federal staffing requirement of one Registered Nurse for eight hours, seven days a week (Harrington, 2008). This bill would ultimately address the fact that these staffing ratios are not sufficient and each patient would receive a total of 4.1 hours by July 1, 2014.
How will this affect the client?
With a smaller nurse to client ratio, nurses will have more time to promote patient well being and patient outcomes.
With less patient ratios, the patient will be safer against medical errors and injuries.
What is the potential impact on Nurses?
Prevent burnout and staff turnover
Less medical errors
Prevent law suits and safety in their liscensure
What is the potential impact on health care?
Patients receiving higher level of of care
Regulations to standardize nurse staffing and contact hours with clients
The Need for Change
The need to address the nursing shortage is echoed across the political spectrum.
According to Jeff Tieman of Modern Healthcare (2002):
Harrington, C. (2008). Nursing home staffing standards in State statues and regulations. University of California.
Piotrowski, J. (2003). Who will care for the elderly? Modern Healthcare, 33(24).
Tieman, J. (2002). Nursing the nurse shortage. Modern Healthcare, 32(20).
- Promote general welfare of patients in nursing homes, both public and private
- Address safety issues such as preventing medical errors and reducing falls
- Impose a penalty for noncompliance by certain deadlines
Staffing regulations vary from state to state. For example, California requires each facility to have 3.2 nursing hours per patient day, whereas Maryland requires a minimal total of 2 hours of direct patient care per day.
There is a federal staffing requirement of one Registered Nurse for eight hours, seven days a week (Harrington, 2008). This bill would ultimately address the fact that these staffing ratios are not sufficient and each patient would receive a total of 4.1 hours by July 1, 2014.
How will this affect the client?
With a smaller nurse to client ratio, nurses will have more time to promote patient well being and patient outcomes.
With less patient ratios, the patient will be safer against medical errors and injuries.
What is the potential impact on Nurses?
Prevent burnout and staff turnover
Less medical errors
Prevent law suits and safety in their liscensure
What is the potential impact on health care?
Patients receiving higher level of of care
Regulations to standardize nurse staffing and contact hours with clients
The Need for Change
The need to address the nursing shortage is echoed across the political spectrum.
According to Jeff Tieman of Modern Healthcare (2002):
- "Three federal agencies-HHS, the Education Department and the Labor Department-announced earlier this month that they will collaborate to address the 'severe shortage of nurses in the Unitied States'"
- "'The shortage of long-term-care workers, if left unaddressed, will affect all Americans in very personal ways,' Labor Secretary Elaine Choa says."
- "Skilled nursing providers...are well-aware that delivering better-quality care means depending upon a bigger quantity of workers."
- "To ensure quality care, consume advocates contend that nursing homes must be more fully staffed."
Harrington, C. (2008). Nursing home staffing standards in State statues and regulations. University of California.
Piotrowski, J. (2003). Who will care for the elderly? Modern Healthcare, 33(24).
Tieman, J. (2002). Nursing the nurse shortage. Modern Healthcare, 32(20).
Key Stakeholders
Key Stakeholders within HB 1046:
- Nursing Home Facility: With the increase in staffing within these facilities a great outcome could be the nursing home gaining a better reputation and excelling in the care of their patients. If the care continues to progress and get better for the patient population, the facility could have the chance to get more money for funding, more patient interest, and their congregation in patients and nurses could easily grow.
- Nursing Staff: The staff at these care facilities is directly influenced by the outcome of this bill. If the bill passes this means an increase in the nurse to patient ratio. This provides for a closer more specified therapeutic relationship. This also allows for the nurses to have a better grasp on what their patient needs and getting their work done safely and correctly. The shortage of nurses and massive number of patients assigned to each nurse has resulted in medical errors in the past and this bill could help to prevent those mistakes.
- Patients and their families: The patients and their families are two of the most important people affected by this bill. More nurses can allow for better care for the patients. This could be a positive for both the patient and the family knowing their loved one is in good hands and getting the attention they need.
- Taxpayers: The taxpayers and the public are also affected by the passage or denial of this bill. If this bill passes how will it effect the average taxes for the constituents in the area. Will taxes increase? Will funding be pulled from somewhere else? How will the public and legislators handle the possible rise in taxes or nursing home bills?
- House of Delegates Patrons: Watts and Plum
- Senate Patrons: Petersen and Whipple
- Nursing Home Facility: With the increase in staffing within these facilities a great outcome could be the nursing home gaining a better reputation and excelling in the care of their patients. If the care continues to progress and get better for the patient population, the facility could have the chance to get more money for funding, more patient interest, and their congregation in patients and nurses could easily grow.
- Nursing Staff: The staff at these care facilities is directly influenced by the outcome of this bill. If the bill passes this means an increase in the nurse to patient ratio. This provides for a closer more specified therapeutic relationship. This also allows for the nurses to have a better grasp on what their patient needs and getting their work done safely and correctly. The shortage of nurses and massive number of patients assigned to each nurse has resulted in medical errors in the past and this bill could help to prevent those mistakes.
- Patients and their families: The patients and their families are two of the most important people affected by this bill. More nurses can allow for better care for the patients. This could be a positive for both the patient and the family knowing their loved one is in good hands and getting the attention they need.
- Taxpayers: The taxpayers and the public are also affected by the passage or denial of this bill. If this bill passes how will it effect the average taxes for the constituents in the area. Will taxes increase? Will funding be pulled from somewhere else? How will the public and legislators handle the possible rise in taxes or nursing home bills?
- House of Delegates Patrons: Watts and Plum
- Senate Patrons: Petersen and Whipple
Wednesday, October 1, 2008
Nursing Home Staffing Requirements
Description of the House Bill 1046:
This bill addresses the need for changes in staffing requirements in nursing homes in order to provide the residents of these care facilities with adequate care. Higher nurse to patient ratios can prevent many complications associated with the chronic and debilitating illnesses experienced by those residing in these facilities. Providing nurses more time to care for clients' physical and psychosocial needs will ensure better care and lifestyle outcomes among this patient population.
This bill proposes the following changes to House Bill 1046:
This bill addresses the need for changes in staffing requirements in nursing homes in order to provide the residents of these care facilities with adequate care. Higher nurse to patient ratios can prevent many complications associated with the chronic and debilitating illnesses experienced by those residing in these facilities. Providing nurses more time to care for clients' physical and psychosocial needs will ensure better care and lifestyle outcomes among this patient population.
This bill proposes the following changes to House Bill 1046:
- By July 1, 2008 the minimum of 3.5 hours of direct care by certified nursing assistants, LPNs, licensed vocational nurses, or RNs per 24 hour period.
- By July 1, 2012 a minimum of 3.9 hours of direct care by certified nursing assistants, LPNs, licensed vocational nurses, or RNs per 24 hour period.
- By July 1, 2014 or upon adoption by Congress, whichever may be sooner, a minimum of 4.1 hours of direct care by certified nursing assistants, LPNs, licensed vocational nurses, or RNs per 24 hour period.
- Any facility that fails to maintain staffing levels sufficient to provide at least 3 hours of direct care per patient by July 1, 2008, shall be ineligible to accept new patients.
- Any facility that fails to maintain staffing levels sufficient to provide at least 3.3 hours of direct care per patient by July 1, 2014, shall be ineligible to accept new patients.
- Total staffing hours shall be determined based on payroll information reported to the internal revenue service for positions identified.
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