Governor Deval Patrick recently signed into law a new measure that requires Massachusetts hospitals to limit the number of patients that registered nurses working in intensive care units (ICUs) will be required to oversee at once. Under the new law, nurses may only be assigned to one patient at a time. In certain circumstances, however, a nurse may be assigned to two patients if the patients are deemed stable enough, based on the assessment of the staff nurses (not managers or supervisors) on that unit.
The state’s Health Policy Commission will regulate implementation of the new law (titled “An Act for Patient Limits in All Hospital Intensive Care Units”), which calls for hospitals to develop an acuity tool to be used by staff nurses in determining if their patient is sufficiently stable to allow for a second patient to be added to the nurse’s assignment. The acuity tool must be certified by the Massachusetts Department of Public Health. The Commission will also provide guidance on the method of reporting to the public on staffing compliance, as well as the identification of three to five related patient safety quality indicators, which will also be measured and reported publicly.
The legislation has an effect of prioritizing patient safety, which, in turn, minimizes the risk of medical errors at the expense of the patient. Hopefully, the implementation of the new law will enable nurses to better focus on the medical needs and progress of ICU patients, and as a result, provide a higher standard of individualized patient care.
Although the original legislative initiative called for nurse-to-patient staffing ratios throughout all hospital units, the applicability of the law to staffing in ICUs is an important step in patient care and patient safety for those who are often most vulnerable to the risk of medical malpractice. Those who have supported the legislation hope to eventually extend similar limitation requirements to all hospital units.