Facts on House Bill 1186
An Act Relative to Sufficient Nurse Staffing
To Ensure Safe Patient Care

This legislation will help to ensure quality patient care at health care facilities. Safe nurse staffing levels equals quality care for patients and reduces cost on our health care system by decreasing lengths of stay, reducing recidivism rates, and curbing other patient complications.

Research shows a direct correlation between the level of nurse staffing and patient outcomes.   Studies over the past 2 decades have clearly shown that the level of care provided by registered nurses decreases the length of stay, decreases patient complications and increases patient satisfaction.  A recent study conducted through the Harvard School of Public Health of 5 million patient discharges found a "strong and consistent" link between nurse staffing levels and patient outcomes.  Adverse outcomes such as gastrointestinal bleeding, pneumonia, and length of stay in hospitals increased as nurse staffing levels decreased.
 
H. 1186 will help alleviate the current nursing shortage. The working conditions that nurses are facing today are driving them out of the profession. Many of the shortage problems that exist today are directly related to the reluctance of licensed nurses not to practice in positions where they are inappropriately rushed through their patient care activities, assigned unsafe patient levels, and confronted by mandatory overtime.  

There currently is no law in Massachusetts that protects patients from unsafe staffing levels in hospitals. There is no current definition of “sufficient” staffing in Massachusetts’s law. H.1186 will facilitate a plan in which each health care facility will work to anticipate, design and adhere to a daily written staffing plan as required by patients or residents to maintain safety and to support nursing staff compliance with applicable professionally recognized standards of nursing practice.

H. 1186 will create a process that will represent the needs of patients, nurses, and hospitals. The major provisions of the legislation include:

• The creation of a nurse staffing commission that must work collaboratively with the Department of Public Health (DPH) in relation to a nurse staffing plan;

• The promulgation of rules and regulations within one year of the passage of this act; 

• That the regulations shall be enforced by DPH and that they b  based upon accepted standards of nursing practice, patient or resident classification system(s), patients’ or residents’ acuity level and functional capacity for self-care;

• The creation of specialty registered nurse positions which increase the quality of patient care including: Nurse Executive, Occupational Health and Safety Nurse, and Quality Assurance Nurse;

• Clear language related to the role of the licensed nurse and the inability for institutions to delegate to unlicensed personnel, duties which demand nursing expertise;   

• The utilization of research by the designated quality assurance registered nurse to evaluate nursing services and nurse staffing in relation to medical errors and patient outcomes;

• Strong consumer protections for “sufficient nurse staffing” including a “prominent posting of the daily written nurse staffing plan on each unit to reflect the nurse to patient ratio per each shift as a means of consumer information and protection; and

• That the facility will provide each patient and/or family member  with a toll-free hotline number for the Division of Health Care Quality at DPH, which may be used to report inadequate nurse staffing. Such complaint shall cause investigation by DPH to determine whether any violation of law or regulation by the facility has occurred and fines for such substantiated violations.