An organization representing nurses in the Commonwealth of Massachusetts in calling for a ballot initiative to improve patient safety by establishing appropriate nurse-to-patient ratios and patient assignments, according to an announcement by the Massachusetts Nurses Association/National Nurses United (MNA/NNU).
The Patient Safety Act is the latest addition to a growing line of requests for legislation on the state and federal level aimed at protecting patients and improving care by more closely monitoring the number and responsibilities of nurses in the clinical environment.
“The research is clear and unequivocal, the most important factor contributing to the health and safety of patients while they are in the hospital is the number of patients your nurse is assigned to care for during his or her shift,” MNA/NNU President Donna Kelly-Williams said in a public statement. “The fact is patients in our hospitals are at greater risk because they are being forced to share their nurse with too many other patients at the same time.”
According to the association, healthcare reform on the local and national level coupled has combined with consolidation and contraction in the provider space to place increased burden on shrinking hospital staff. Not only does this threaten patient safety, but it also works against the purpose of reform efforts.
“Massachusetts hospitals were among the most heavily penalized by Medicare last year for preventable readmission of patients,” states the MNA/NNU release. “In fact 54 of the state’s 67 hospitals were penalized by Medicare for poor care last year, and several received the highest penalty possible.”
Conversely, since the early 2000s, California has demonstrated improvements to patient outcomes and safety following the enactment of legislation similar to that proposed by the MNA/NNU in Massachusetts.
“For the better part of 15 years we nurses, along with more than 100 allied health care and consumer groups, have attempted to improve patient care by asking our legislature to create a law that stipulates the maximum number of patients a nurse can safely care for at one time,” explained Kelly-Williams. “While we continue to push for a legislative solution, should the legislature fail to act, we are taking this issue directly to those who are most impacted and placed at risk by this issue – the voters.”
As detailed by the association, the major provisions of the bill would:
• establish maximum thresholds for nursing patient limits based on the hospital unit or department (e.g., one nurse for every four patients in medical/surgical units);
• create an acuity system for determining the appropriate amount of staffing required for patients based on the severity of their conditions;
• prevent hospitals from satisfying nursing staff requirements by reducing the number of other staff;
• fine violating hospitals $25,000 for each day they are non-compliant.
Considering the amount of emerging research showing a correlation between the ratio of hospital staff to patients, efforts on the part of healthcare organizations and providers to limit the size of their staff appear to be undermining the efficacious of healthcare reform at any level.