REGULATING RN-TO-PATIENT RATIOS

Registered Nurses throughout Massachusetts have been working towards passage of Quality Patient Care/Safe Staffing Legislation, which would require registered nurse-to-patient ratios in acute care hospitals. This subject matter is now before the conference committee considering the Fiscal Year 2003 State Budget. This vehicle provides a tremendous opportunity, with modifications, to solve problems related to quality patient care outcomes.

We urge your support and assistance with this issue because patients can’t wait.

RN Staffing = Quality Patient Care

Patients in Massachusetts hospitals are sharing their nurse with too many other patients. This is dangerous - under such conditions, nurses are forced to rush through their patient care activities and mistakes and preventable errors become more likely to occur.

Improving and regulating Registered Nurse-to-Patient ratios will ensure quality patient care, retain experienced nurses, recruit new nurses into the profession and save money in two ways: First, patients will receive better care, which will lead to fewer medical complications and unnecessary hospital stays. Second, there will be less turnover among Registered Nurses who are currently leaving the profession because they are forced to care for too many patients at once, compromising patient care and endangering their license. This will save money currently spent on training new hires and on temporary nurse staffing arrangements.

Several objective studies have cited the significant impact that Registered Nurses have on patient care. The May 30th New England Journal of Medicine released a study that clearly reinforces our position. Unsafe staffing levels put patients at risk for life-threatening infections, shock, and bleeding. Staffing levels directly impact patient health and survival rates. For nurses in Massachusetts, the Journal's findings provide additional strong scientific evidence supporting MNA legislation that is much needed and long overdue.

The Journal study is the most comprehensive to date, and includes hospital discharge data for more than 6 million patients from 799 hospitals in eleven states, including Massachusetts. The research concludes that the number of patients assigned to each Registered Nurse has a critical impact on the health of patients. Researchers found a clear correlation between staffing ratios and six of the leading adverse patient outcomes, from infections to cardiac arrest. When staffing ratios are where they should be, there is a reduction in all adverse outcomes.


Improving RN staffing levels saves money.

Studies have found a cost savings associated with improved Registered Nurse staffing. All hospitals stand to achieve cost savings that will accrue with safe ratios, including reduced expenditures on temporary nursing arrangements, travel nurses, overtime costs, reduced RN turnover, and improved patient outcomes:

• Savings to the health care system in shorter patient lengths of stays
  A 2001 Harvard School of Public Health study for the U.S. Health Resources Services Administration cites a 3% to 6% shorter length of stay for patients in hospitals with a high percentage of front-line Registered Nurses. Other research studies also document a link between front-line Registered Nurses studies and lower costs. Johns Hopkins University researchers, for example, have found that patients with fewer front-line Registered Nurses in intensive care units at night incurred a whopping 14% increase in hospital costs. A study in progress by James Bramble, PhD of Creighton University, presented publicly in June 2001, reports that higher levels of front-line Registered Nurses staffing are associated with significantly lower costs and shorter lengths of stay for patients at risk for pneumonia, urinary tract infections and venous thrombosis or pulmonary embolism.
  
• Savings on temporary RN staff.
  Hospitals across the U.S. spent $7.2 billion last year for temporary employees. The projection for next year is $10.6 billion nationally. Most of that expenditure is for front-line Registered Nurses. For travel nurses, hospitals must often provide travel costs, room and board, meal allowances, and other expenses, in addition to higher wages than are paid for permanent front-line Registered Nurses. Travel nurse companies typically charge hospitals double or triple the average pay rate for staff RNs.

Improving RN staffing levels will significantly reduce the cost of temporary and travel nurses.

• Savings in reduced RN turnover.
  RN turnover rates exist in large part due to the unsafe patient loads nurses are forced to work with. There are 105,000 licensed registered nurses in Massachusetts – more licensed RNs per capita than any state in the country. The alleged “shortage” exists because front-line Registered Nurses have left the hospital work environment due to the failure of the hospital industry to establish and maintain safe patient care ratios. The Massachusetts Colleagues in Caring Collaborative, an initiative of UMass, in a survey of the state’s nurses, found that those who have left nursing positions in the last 2 years, cited patient load and unsafe staffing as the key reasons for leaving the profession.

Last month, more than 80,000 people in Massachusetts signed petition in support of Quality Patient Care/Safe Staffing legislation that would regulate Registered Nurse-to-patient ratios to ensure patient care.

In addition, a January 2002 poll of Massachusetts voters conducted by Opinion Dynamics Corporation found that more than 75% favored the state regulating RN-to-patient ratios.