Massachusetts regulates nurse staffing levels in ICUs

Amid rising concerns about unsafe nurse staffing levels nationwide, Massachusetts on Wednesday became the second state to explicitly regulate nurse-to-patient ratios in its hospitals, the Boston Globe reports.

The state Health Policy Commission (HPC) voted unanimously to approve the new regulations, which require hospitals to assign intensive care nurses no more than two patients at a time. Since Massachusetts' new rules apply only to intensive care units (ICUs), California remains the only state to require all care units to cap their nurse-to-patient ratios, according to the American Nurses Association.

Nursing groups in other states, including Oregon, New Jersey and Minnesota, continue to push for similar rules, FierceHealthcare has reported. But such efforts have faced opposition from industry groups--in Minnesota, for example, the state nurses association accused hospitals of refusing to provide data for a study it hoped would identify ideal nurse-patient ratios. Previous research has been able to link nurse staffing ratios to the quality of care.

The new Massachusetts regulations represent a compromise between the Massachusetts Nurses Association (MNA) and the Massachusetts Hospital Association (MHA), according to the Globe. The MNA had pushed for 1:1 nurse-to-patient ratios in nearly all ICU cases, while the MHA had lobbied for exemptions for specialty care units such as neonatal ICUs, arguing that unpredictable patient loads in such units may make compliance difficult.

"We couldn't imagine how any responsible public official could support a policy that provides a lower standard of care for critically ill babies, and we are very pleased that the HPC came to the same conclusion and agreed to follow the law," MNA President Donna Kelly-Williams, R.N., said in a statement regarding the new rules.

The MNA also worries that the rules give hospital management too much power to guide staffing decisions and fail to require hospitals to inform patients and their families of the new standards, according to the statement. The MHA, however, seemed pleased with the compromise.

"Overall, the commission found a thoughtful, patient- focused balance," Timothy F. Gens, executive vice president of the MHA, told the Globe.

To learn more:
- check out the ANA's fact sheet
- read the article
- here's the statement