title: Registered nurses' perceptions of nurse staffing ratios and new hospital payment regulations.
abstract: 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.
authors.affiliation: Center for Interdisciplinary Health Workforce Studies, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Peter I
authors.initials: PI
authors.lastname: Buerhaus
authors.forename: Karen
authors.initials: K
authors.lastname: Donelan
authors.forename: Catherine
authors.initials: C
authors.lastname: DesRoches
authors.forename: Robert
authors.initials: R
authors.lastname: Hess
mesh_terms: D001291:Attitude of Health Personnel; D014487:Centers for Medicare and Medicaid Services, U.S. / Q000458:organization & administration*; D005161:Facility Regulation and Control / Q000458:organization & administration; D033161:Government Regulation; D006801:Humans; D037141:Mandatory Programs; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D009936:Organizational Innovation; D016134:Organizational Policy; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D012051:Reimbursement Mechanisms / Q000458:organization & administration*; D012456:Salaries and Fringe Benefits; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000458:organization & administration; D014481:United States; D016526:Workload / Q000523:psychology / Q000706:statistics & numerical data