Labor to mandate nurse-to-patient ratios in hospital emergency departments

Every nurse in the state’s emergency wards will be responsible for no more than three patients at a time under a Labor election policy released on Tuesday, writes Amy Corderoy in the Sydney Morning Herald.

Labor has promised to enshrine the nurse-to-patient ratio in law under the plan, which will also legislate for a one-to-one ratio for hospital resuscitation beds.

Labor health spokesman Walt Secord said the plan would cut errors, speed up patient recovery and potentially save lives.

“l listen to patients, nurses and international researchers, who all agree that increased nurse-to-patient ratios in hospitals saved lives,” he said. “I have been absolutely convinced by the data.”

Nurse-to-patient ratios have been an increasing area of international research. Many studies have found the more patients that nurses are caring for, the greater the risk of complications such as infections and even death.

However, most research has centred on unintentional fluctuations in nurse numbers, so few studies have been able to examine the affect of enabling specific ratios to improve patient care.

Liberal Premier Mike Baird and Health Minister Jillian Skinner have rubbished the plan, saying it is inflexible and will only add a small number of nurses to the system.

NSW Labor leader Luke Foley said requiring the one-to-three ratio in emergency departments would be an “Australian first”.

“This will help our nurses do their jobs and will help patients, and that’s the important thing here,” he said.

Flanked by federal Labor leader Bill Shorten, and candidates from the St George area, Labor was keen to capitalise on discontent over the federal government’s troubled plans to reduce bulk-billed GP consultations.

Mr Shorten said the federal government had flagged $16.5 billion worth of cuts to hospitals “and we haven’t heard any real resistance out of the state Premier Mr Baird”.

“Who will do the best job for standing up for the health system in NSW? Today’s announcement shows it’s Luke Foley and Labor,” he said.

The nurse ratio plan would cost an estimated $96 million over the next term of Parliament, and would be rolled out across 75 emergency departments and paediatric wards. Overall, 840 new nurses would be hired: 735 in emergency departments and 105 in paediatric wards.

NSW Nurses and Midwives Association secretary Brett Holmes said research had shown for every one patient added to a nurse’s workload, there was a 7 per cent increase in mortality after common surgical procedures.

However, he said neither party had yet committed to ensuring equal ratios across the state.

“It means if you are in Royal Prince Alfred Hospital in Sydney and you have a hip operation, you are entitled to six nursing hours per day, but if you are in Goulburn and have the same operation, you will only get five hours allocated to you,” he said.

He rejected a claim from  Mrs Skinner that the government was introducing a different measure called nursing hours per patient day.

Mrs Skinner said her measure “allows nurse and hospital managers the flexibility to allocate nursing hours in a way that matches the busiest times and patient needs”.

But Mr Holmes said she was muddying the waters with confusing terms that meant the same thing.

“This is about accountability and transparency,” he said. “There are currently no ‘nursing hours per patient day’ in paediatrics or emergency departments [anyway], so this is putting them where they haven’t been before.”

Mr Baird said the announcement of a set ratio of nurses to patients was “not funded, not happening” and a policy “starting to unravel before it starts”, noting former Labor health minister Carmel Tebbutt had rejected nurse ratios in 2011.

“We’ve got the budget under control . . . Over the past four years we have delivered 3400 extra nurses. We promised 2600,” he said.

“We delivered more than that because we have the capacity that doesn’t happen by chance.”

Mrs Skinner said Labor was putting politics before patients.

“This announcement shows Luke Foley still has training wheels on when it comes to understanding the management of the state’s health system,” she said.

“Labor is playing a dangerous game with patient care. Legislating sweetheart deals with unions will lock in inflexible working arrangements and prevent hospitals from adopting modern, best-practice approaches to patient care.”

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