Senator Michael Skindell Introduces Ohio Patient Protection Act
Bill would increase patient safety by regulating nurse-to-patient ratios in Ohio
Posted February 14, 2017 by Minority Caucus

COLUMBUS – Today, State Senator Michael Skindell (D- Lakewood) will re-introduce the Ohio Patient Protection Act. This bill, Senate Bill 55, would increase patient safety by setting limits on the number of patients a registered nurse (RN) may care for at one time. The nurse-to-patient ratio requirements would be based on the seriousness of the condition being treated or the medical procedure that each respective patient is undergoing. 

“These policies will help ensure that patients get the best medical care based on need. The bill will also make sure nurses are protected from retaliation for whistleblowing or refusing to follow potential violations of the law,” said Senator Skindell. “Genuine and enforceable safe-staffing standards will save money and lives by ensuring that patients obtain excellent nursing care."

The legislation would require a minimum numerical nurse-to-patient ratio with a provision that additional nurses be added when needed. 

Specific requirements in the bill:

  • A one-to-one patient ratio (one nurse for every patient) would be required for:
    • Patients in an operating room
    • Patients in a trauma or critical care unit.
    • Unstable newborns
    • Patients requiring resuscitation
  • An intermediate ratio level – one nurse to three patients – would be required for pediatric units and pregnant patients who are not in active labor. Certain other situations – such as infants in nurseries – would require a one-to-five nurse-patient threshold.
  • For units not listed in the legislation, a hospital-wide nursing care committee would establish ratio requirements and implement them.  When setting the ratio requirements, the committee should consider factors such as the severity of a patient’s illness, the need for patient advocacy, the patient-care delivery system, and the hospital’s physical layout. The bill would require hospitals to post these ratio requirements in public view.
  • In addition, the legislation would:
    • Require that the nurses assigned to each unit must be competent to work in the units for which they are providing care. 
    • Prohibit such mandatory overtime to meet the ratio requirements
    • Prohibit the use of cameras or monitors as substitutes for the actual nurse to fulfill the requirements.

The bill provides various protections to nurses for refusal to follow a policy they believe in good faith to be in violation of the legislation. It includes prohibitions on discrimination and discharge for such a good-faith refusal.

Members of the medical community joined the senator at today’s press conference to express their support for the senator’s legislation.

Michelle Mahon, RN, National Representative – National Nurses United (NNU):

“NNU nurses have witnessed first hand the dramatic improvements in patient care conditions that resulted from the implementation of the California staffing legislation. This life-saving measure should be extended to Ohio patients as well. Unfortunately, hospital corporations continue to place an emphasis on the bottom line, and care suffers. As patient advocates, Ohio nurses fight daily battles with hospital management to ensure that there are enough nurses to care for patients. Our patients deserve the guarantee that when they are most vulnerable they will have the constant vigilance of a skilled registered nurse to protect them.”

Rhonda Risner, RN, Dayton VA Medical Center in Dayton, Ohio:

“Studies have shown again and again that safe nurse-to-patient staffing ratios save lives.”

Debra McKinney, RN, Affinity Medical Center in Massillon, Ohio:

“With no limit on the number of patients we care for, we have a safety crisis on our hands in Ohio. Hospital administrators are free to cut corners on staffing and put their bottom line over patient safety. We need a mandatory, non-negotiable limit to the number of patients each nurse cares for in order to protect our patients from harm—and also to protect nurses and other healthcare staff.”

Susan Pratt, RN, President – UAW Local 2213:

"As patient acuity increases, so does the pressure for faster turnaround times on patient loads. These changes on increasing productivity and throughput in our industry have left little room for patients and their specific needs. Our patient is not a product or a part, they are a human being with all complexities that make us unique." 

Ohio currently has no limits on how many patients a nurse can care for at any one time.

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