Assignment: Regulation for Nursing Practice Staff Development Meeting Presentation

Assignment: Regulation for Nursing Practice Staff Development Meeting Presentation

Assignment: Regulation for Nursing Practice Staff Development Meeting Presentation

Describe at least one state regulation related to general nurse scope of practice. ( I already started it but I wqanted a toic regulations in New jersey with regards to nursing staffing compared to California)

How does this regulation influence the nurse’s role?

How does this regulation influence delivery, cost, and access to healthcare?

If a patient is from another culture, how would this regulation impact the nurse’s care/education

Has there been any change to the regulation within the past 5 years? Explain.

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Nurse Staffing Regulations: New Jersey vs. California

One significant regulation related to the general nurse scope of practice concerns nurse staffing ratios. This regulation outlines the staffing standards and determines the number of nurses required to attend to the patients in different units (McHugh et al., 2021). Although some states have set laws regarding nurse staffing, there are disparities between the states, such as New Jersey and California. New Jersey has no mandated or enforced nurse staffing standards for patient ratios but obligates the hospitals to have a staffing plan. These have to be linked to factors such as the understanding of patients admitted, the skill mixes of the staff involved, the issues of safety of clients, and the quality of care delivered. In particular, the New Jersey Department of Health has established that these staffing plans must be publicized and updated at specific intervals for compliance with legal standards. New Jersey Board of Nursing (NJBON) defines minimum competency standards for nurses practicing in the state. These standards outline nurses’ skills and knowledge expected in different practice settings (New Jersey Legislature, 2020). New Jersey emphasizes ensuring nurses are well-equipped to provide quality care (New Jersey Department of Health, 2023).

On the other hand, California has specific nurse-to-patient ratio laws under Title 22, California Code of Regulations (Hollowell, 2023). Since 2004, California has mandated minimum nurse-to-patient ratios in acute care hospitals, such as 1:5 medical-surgical units and 1:2 intensive care units (Wong, 2020). These ratios are meant to reduce the nurses’ workload, enhance patient outcomes, and address the high burnout among the nursing staff.

Influence on the Nurse’s Role

Nurse staffing regulations significantly impact the role of nurses in both states, influencing how they allocate their time. Nurses in New Jersey work within a framework that emphasizes flexibility and adaptability. Without strict conformity regarding the ratios above, the nurses may receive different workloads depending on the particular staffing plan in the given hospital (Griffiths et al., 2020). The nurse’s role may involve more delegation and collaboration with other healthcare professionals due to flexibility in staffing. This allows nurses to focus on tasks requiring their specific expertise (New Jersey Department of Health, 2023). This approach calls for flexibility on the part of the nurses, as the number of patients each nurse attends to and the severity of illnesses treated varies significantly at different moments. This lack of apparent ratios can also increase the burden on nurses to demand adequate coverage levels to deliver quality care and protect their patients.

In California, the fixed nurse-to-patient ratios provide a more predictable and manageable workload for nurses. California’s mandated ratios might lead to a more direct bedside care approach. This regulation enhances the establishment of a standard work setting in the nursing profession since the number of patients the nurses are expected to attend to for the day is predetermined, so they can prepare well and address the number of clients they will handle during the working day (Hollowell, 2023). These ratios also enable the nurses to spend more time with the patients and less on non-nursing duties or lobbying for enough human resources.

Influence on Delivery, Cost, and Access to Healthcare

The flexible staffing plans in New Jersey can lead to variability in care delivery. Patient care plans can help achieve higher hospital standards, whereas a lack of or poor quality of plans can lead to ‘quality’ problems in these facilities (New Jersey Department of Health, 2023). Lack of mandatory staffing ratios can also lessen hospital staffing expenses because hospitals may hire more or fewer persons depending on the workload. Still, the lack of staff compromises the effectiveness of healthcare delivery as the patients experience other associated costs, such as recurrent admissions and more extended hospital stays. Being able to change staffing may also enable hospitals to be rational in the use of resources and possibly attend to more patients. However, there are disadvantages, such as staff shortages, that may affect overall patient experience and thus reduce satisfaction levels.

The prescribed ratios in California are helpful as they ensure constant quality and relevant care delivery. They acknowledge that patient care requires adequate time, which is relatively easy as nurses can spend more time with each patient, improving the quality of care and thus reporting high satisfaction (McHugh et al., 2021). Although these ratios put a financial and staffing burden on hospitals, cost savings can be seen regarding the quality of patient care and diminished rates of adverse occurrences. This regulation can also reduce its upstream costs of excessive fatigue and turnover of nurses on the wards. The need for more nurses may pressure the available nurses’ pool, reducing access to health services in some areas. However, the general satisfaction index among the patients is relatively higher since healthcare quality, ranging from diagnosis to treatment, is usually higher.

Cultural Considerations

Nurses in New Jersey must be culturally competent and prepared to address the diverse needs of patients. The flexible staffing model requires nurses to be adaptable and skilled in managing various cultural expectations and health beliefs. Nurses may need to advocate for additional resources and training to deliver culturally sensitive care, especially in hospitals with less rigid staffing structures. In California, consistent staffing ratios allow nurses to spend more time understanding and addressing the cultural needs of their patients. This can lead to more personalized and effective care plans. With mandated ratios, there is more opportunity for nurses to engage in ongoing education and training focused on cultural competence, enhancing their ability to provide inclusive and respectful care.

Changes in Regulation Over the Past Five Years

In recent years, there have been ongoing discussions and legislative efforts to address nurse staffing issues in New Jersey and California. While New Jersey has not adopted fixed nurse-to-patient ratios, there has been increased emphasis on transparency and accountability in staffing plans (New Jersey Department of Health, 2023). Recent changes include stricter reporting requirements and enhanced scrutiny of hospital staffing practices by the New Jersey Department of Health. California’s nurse staffing ratio laws have remained unchanged regarding the specific ratios. However, there has been increased focus on enforcement and compliance, ensuring hospitals adhere to the mandated ratios. Additionally, there have been discussions about extending ratio requirements to other healthcare settings, such as outpatient clinics and long-term care facilities.

Conclusion

Nurse staffing standards are essential as they outline the capacities of nurses to be deployed and consequently influence the nursing profession and healthcare sector. Thus, the minimal differences between New Jersey’s flexible staffing plans and the requirements for ratios of California show how the states approach the problem of quality care and patient safety differently. They both have budgetary considerations for consumers and providers, concerns about increased access and availability of services, and considerations about the cultural competence of the services being delivered. Accompanying modifications of policies in the last few months show that current processes of staffing optimization are still being implemented to enhance healthcare in both states.

References

Griffiths, P., Saville, C., Ball, J., Jones, J., Pattison, N., & Monks, T. (2020). Nursing workload, nurse staffing methodologies & tools: A systematic scoping review & discussion. International Journal of Nursing Studies, 103(1), 103487. https://doi.org/10.1016/j.ijnurstu.2019.103487

Hollowell, A. (2023, February 16). California’s mandatory nurse staffing ratios: Key lessons 2 decades in. Www.beckershospitalreview.com. https://www.beckershospitalreview.com/nursing/californias-mandatory-nurse-staffing-ratios-key-lessons-2-decades-in.html

McHugh, M., Aiken, L., Sloane, D., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: A prospective study in a panel of hospitals. The Lancet, 397(10288), 1905–1913. https://doi.org/10.1016/S0140-6736(21)00768-

New Jersey Department of Health. (2023). Department of Health | Health Care Quality Assessment. Www.nj.gov. https://www.nj.gov/health/healthcarequality/health-care-professionals/nurse-to-patient-staffing/

New Jersey Legislature. (2020). New Jersey legislature. Www.njleg.state.nj.us. http://www.njleg.state.nj.us/

Wong, J. L. (2020). State nursing staffing laws related to hospital-acquired infections (hais). Escholarship.org. https://escholarship.org/uc/item/26m0s00c