Buerhaus Peter I, Donelan Karen, DesRoches Catherine, Hess Robert
Center for Interdisciplinary Health Workforce Studies, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.
Nurs Econ. 2009 Nov-Dec;27(6):372-6.
Two regulatory initiatives weigh heavily on the nursing workforce: establishing minimum patient-to-nurse staffing ratios in hospitals and payment policy that eliminates payment to hospitals for negative consequences of care. Although the majority of RNs favor ratios, results also indicate that a good number of RNs either do not support ratios or are unsure, which suggests that while strong support for ratios exists, the support is not universal. With regard to the Centers for Medicare and Medicaid Services hospital payment regulations, while many RNs expect that this policy change will increase the emphasis on prevention and additional education and training, RNs also believe they will be blamed if adverse patient conditions occur. A clear majority think that their work will increase, and only a small percentage of RNs think the regulations will lead to added respect, more staffing, higher pay, or raise their status. Beyond affecting the clinical environment, both regulations will impact RNs' economic value in the eyes of the hospitals that employ them.
在医院设定最低的护患人员配备比例，以及实行一项支付政策，即医院因护理产生的负面后果而得不到支付。尽管大多数注册护士支持设定比例，但结果也表明，相当数量的注册护士要么不支持比例设定，要么不确定，这表明虽然对比例设定存在强烈支持，但这种支持并不普遍。关于医疗保险和医疗补助服务中心的医院支付规定，虽然许多注册护士预计这一政策变化将增加对预防以及额外教育和培训的重视，但注册护士们也认为，如果出现患者不良状况，他们将受到指责。绝大多数人认为他们的工作量将会增加，只有一小部分注册护士认为这些规定会带来更多尊重、更多人员配备、更高薪酬或提升他们的地位。除了影响临床环境外，这两项规定还将影响注册护士在雇用他们的医院眼中的经济价值。
