Decreasing nurse-to-patient ratios could help improve patient care in Ohio

Preventable medical errors are the third leading cause of death in the U.S., a 2016 study found, but a new bill hopes to address the problem by reducing the workload nurses face in Ohio hospitals.The legislation, sponsored by Sen. Michael Skindell, D-Lakewood, sets specific nurse-to-patient ratios and protects nurses who refuse to follow hospital directions that break the proposed law.If hospitals want to cut down on medical accidents, they should focus on decreasing nursing workload, Ohio Nurses Association CEO Lori Chovanak said.“Staffing directly impacts the error rate, so for instance for every hour that a nurse works over eight hours, the chances of a medical error increase,” Chovanak said. “(Nurses work) 12 hour shifts on average in the acute care setting...the number one priority is we need to pay attention to staffing practices and build on the current law.”Although she said she had not reviewed the legislation yet, Chovanak said proposed ratios would not be enough to address staffing and patient care issues. “We are working to strengthen the current staffing law to reflect that nurses have the professional responsibility to assess themselves and their ability to work versus having it mandated,” Chovanak said. “Insuring that it includes making sure that the patient acuity and the skills of the nurses are considered. That language would have to be more than just ratios.”The proposed bill calls for one direct-care nurse for, among others, every patient in an operating room, every critical care patient in an emergency department and every patient in active labor. It increases the ratio for patients in less-threatening situations. Earlier in February, supporters visited the Ohio Statehouse to talk about the benefits such a law could provide. One supporter who works with National Nurses United, Michelle Mahon, said a similar law passed in California in 2004 was a success."No hospital has closed. No hospitals went bankrupt. More nurses came to the profession," Mahon said. "And nurses now are satisfied with the care they are able to provide."Still, others, such as Chovanak, said flexibility would be an important part of any staffing regulation change that would help increase patient care levels, since different hospitals have different needs. However, she also said the current process, in which committees at each hospital establish their own policies, is problematic because those committees have to outline what is safe and appropriate. “We need to make sure that in those environments nurses aren’t working fatigued,” Chovanak said. “We need to collaborate on what is the answer.”