Proposals have been made to tighten nurse-to-patient ratio laws in an Australian state, which was one of the first in the world to legally mandate nurse staffing numbers a decade ago.
The state government of Victoria, on the southeastern tip of mainland Australia, announced this week that it was amending its 2015 legislation on nurse ratios.
“These reforms will mean an extra pair of hands, and an extra set of eyes, for some of our most precious patients”
Jacinta Allan
The changes to the Staff Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act, if passed, would “put more nurses and midwives on shift – at all hours of the day”, according to government leaders.
They would see a 1:1 nurse-to-patient ratio implemented in intensive care units (ICUs) on all shifts in “level 1” and “level 2” hospitals, and ICUs would also require a team leader and liaison nurse for the first time.
For emergency deparments, the amendment would bring staffing ratios for morning shifts in resuscitation cubicles in line with afternoon and night shifts. Previously, ratios for morning shifts were laxer.
Further, it would improve midwife-to-patient ratios for night shifts to 1:4 from 1:6 on postnatal and antenatal wards and mandate a lead nurse on all night shifts in standalone high dependency and coronary care units.
These new rules would apply only to Victoria as this is state, not federal, policy.
State premier Jacinta Allan introduced the amendments, via a bill, to the parliament of Victoria on 19 February. As per the Victorian parliamentary process, MPs are now being given time to consider the bill before a debate and vote.
Ms Allan also announced an investment of $101.3m for the additional workforce needs the stricter ratios would likely result in.
Victoria’s minister for health, Mary-Anne Thomas, said the tightening of ratios would improve care, as well as support nursing and midwifery staff in Victoria.
The Australian Nursing and Midwifery Federation (ANMF), the country’s largest union for nurses and midwives, was consulted on the proposed amendments, as were staff and healthcare providers, Ms Allan’s office said.
Victoria, in 2015, became the first state in Australia to mandate, by law, nurse-to-patient staffing ratios, having first introduced ratios in 2000.
This followed the successful implementation of the world’s first legally-backed nurse staffing ratios in California, US, which was fully implemented in 2004.
The 2015 law in Victoria mandated nurse-to-patient ratios for general or surgical wards of 1:4 for morning and afternoon shifts, and 1:8 for night shifts, in “level 1” hospitals, as well as other rules.
It was amended in 2019 to improve ratios and create new ones, and then again in 2020.
Ms Allan added, following the announcement of the latest proposed amendment to the law: “Anyone who’s experienced the incredible care of our nurses and midwives knows just how special their work really is.
“These reforms will mean an extra pair of hands, and an extra set of eyes, for some of our most precious patients.”
