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This is a major victory for the MNA/NNU, all nurses in Massachusetts and most importantly, for our patients.

To learn more about the law and how it works, follow this link to a video of an MNA/NNU press conference featuring MNA/NNU President Donna Kelly-Williams and State Representative Denis Garlick, RN (D-Needham) providing an in depth description of the new law: The law protects nurses by prohibiting any discrimination, dismissal, discharge or any other employment decision based on a nurses' refusal to accept work in excess of the limitations on mandatory overtime. We are dedicated to making sure this law works the way that the Legislature intended.

This article will argue for the benefits of implementing a nursing intensity adjustment for nursing care by briefly reviewing the process by which nurses lost their economic independence; describing the gap between the supply and demand for registered nurses; presenting the arguments for and against mandatory, nurse-to-patient staffing ratios; offering a different approach for increasing the number of registered nurses at the bedside, namely nursing intensity billing; proposing sources of funding to pay for nursing intensity billing; and identifying limitations of nursing intensity billing. This situation has motivated some state legislatures to enact or consider regulatory measures to assure adequate staffing.

These regulatory measures assign some minimum level of staffing that all hospitals must meet regardless of the types and severity of patients.

Many states have enacted or are considering laws prohibiting mandatory overtime. Trinkoff, A., Geiger-Brown, J., Brady, B., Lipscomb, J., Muntaner, C.

RATIONALE: The Institute of Medicine (1999) found the likelihood of making an error increases when a health care worker works more than 12 hours and is fatigued.

These data could provide a method to compare nursing care across different hospitals and allow reporting of nursing care intensity trends for individual patients within each DRG, which in turn could provide a basis for identifying which hospitals are performing well and which are not. Delaney (Eds.), Proceedings of NI2006: The 9th International Congress on Nursing Informatics, Seoul Korea June 11-15, 2006 (pp.

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The revenue code data, used to charge for inpatient nursing care, could be used to benchmark and evaluate inpatient nursing care performance by case mix across hospitals. In the past several years, there has been a growing need for more registered nurses in hospitals due to rising acuity of patients and shorter lengths of stay.

However, mandatory ratios, if imposed nationally, may result in increased overall costs of care with no guarantees for improvement in quality or positive outcomes of hospitalization.

The costs associated with the additional registered nurses that will be needed for the higher, mandated ratios will not be offset by additional payments to hospitals, resulting in mandates that will be unfunded.

An alternative method that has the potential to improve inpatient nurse staffing and improve payment to hospitals would be to directly link the costs and billing for inpatient nursing care with hospital reimbursement. Journal of Nursing Administration, 30(6):309-15, 2000 Jun, 37, 164-166.

This article will explore an approach that would link cost and billing with reimbursement by separating nursing care from daily room and board charges and billing for nursing care based on the actual hours of care delivered to patients.

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