10.24.2007

Massachusetts Patients Say Nurse Understaffing Compromises Patient Safety

Statewide Survey Finds More Than 235,000 (>1-in-4) Patients Per Year Feel Their Safety Has Been Compromised in Bay State Hospitals

Hospital Industry's "Patients First" Website No Help

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Background on the Patient Safety Act

Boston, MA—More than one-quarter of Massachusetts’ hospital patients and their families (28%) say that their safety, or a family member’s safety, was compromised by nurse understaffing, according to a statewide survey conducted by Opinion Dynamics Corporation (ODC) of Cambridge, Massachusetts. Based on the total number of hospital stays in the Commonwealth as tabulated by the state’s Department of Health Care, Finance and Policy, this translates into more than 235,000 Massachusetts patients annually who feel that their safety is compromised by a lack of available nurses. The new data is being presented today at a State House hearing on pending legislation to establish safe nurse staffing levels in Massachusetts’ hospitals.

In addition, more than one-third of these past patients and their families (35%) say that their nurse had too many patients to care for at once during their hospital stays. Half of all respondents (49%) report they feel that a higher quality of care could have been achieved while they were in the hospital if their nurses had fewer patients to care for at one time. Almost three-quarters of these patients (73%) say that the overall quality of patient care in Massachusetts hospitals is suffering due to nurse understaffing.

“Massachusetts patients are saying loudly and clearly that they are concerned about the impact that the persistent understaffing of nurses in Massachusetts hospitals is having on the safety of their care during their hospital stays,” said John McCormack, co-chair of The Coalition to Protect Massachusetts Patients, an alliance of 125 of the state’s leading health-care and consumer organizations (see list, attached). “An alarming number of hospital patients feel that patient care in hospitals is compromised by their nurses’ workloads, and that is making them fear for their safety.”

Survey respondents also provided new information indicating that the hospital industry’s program of posting nurse-staffing averages on the industry’s “Patients First” web site has little or no value for prospective patients. Nearly 9 in 10 patients report that they did not have the time to use the site to research staffing levels prior to their hospital visits. Only 14% were aware of the web site, and only 4% used it.

“Every day in hospitals across the Commonwealth, patients are suffering because of nurse understaffing,” said Karen Higgins R.N., the other co-chair of the Coalition. “Every patient is at risk of getting dangerously sick in the hospital or dying. One reason that this is an issue is that nurses are regularly forced to care for 6, 8 or 10 patients when they cannot possibly be in ten places at once. A hospital-sponsored website, especially one that patients say they don’t use, is not going to fix that condition. ”

The belief that the safety of care was compromised appears to stem from the fact that important elements of care are not being delivered expeditiously.

• More than one-third of past patients and their immediate family members (43%) report nurses did not always arrive promptly when they pushed their call buttons for assistance.
• More than a third (38%) also report that medicine or other treatments were not always provided in a timely fashion.
• One in five patients (21%) report that nurses did not always arrive promptly if complications arose.

Delays in care and nurse responsiveness have deadly consequences for hospital patients, according to numerous studies. Press Gany Associates, the nation’s leading patient satisfaction research organization, issued a report in August that links a delay in nurses’ responses to call buttons to an increase in hospital-acquired infections and patient deaths. HealthGrades, another leading health-care quality research firm, reported last year that as many as 80,000 elderly patients die each year in hospitals from preventable medical errors, citing “failure to rescue,” which is a medical-research term that refers to a nurse’s failure to promptly assess and treat patient conditions that develop in the hospital.

Rise in Hospital Infections Alarms Patients
The survey results come at a time when state and national health care agencies are raising a red flag about the increasing dangers associated with a hospital stay, specifically a rise in the incidence of hospital-acquired infections that the CDC estimates kills more people every year than AIDS.

The CDC further estimates that 2,000 patients, or 6 per day, are dying in the Commonwealth annually because of hospital-acquired infections and medical errors.

Survey respondents are equally worried. An astonishing 91% of past patients surveyed say they are concerned about the more than 2 million people nationally who become ill from infections while they are in the hospital, and about the fact that, of this number, more than 90,000 patients die.

As noted above, a number of studies link the rise in these infections and other medical complications to understaffing of nurses, including one published in the July issue of the journal Medical Care that found that safer RN staffing levels could reduce the incidence of hospital-acquired infections by a remarkable 68%.

The statewide survey will be discussed at a State House hearing on the House Bill 2059, The Patient Safety Act, which its advocates believe is the key solution to the safety crisis in hospitals. The legislation, calls on the state’s Department of Public Health (DPH) to set a safe limit on the number of patients a nurse is assigned to care for at once, requires that staffing levels be adjusted based on patient needs, bans the dangerous practice of mandatory overtime, and includes initiatives to increase nurse-faculty and nurse recruitment. Members of The Coalition to Protect Massachusetts Patients from throughout the Commonwealth will converge on Beacon Hill to urge lawmakers to pass the legislation.

The survey found overwhelming support for the Patient Safety Act by recent hospital patients, with 8-in-10 patients supporting legislation to set safe limits on nurses’ patient assignments.

The ODC survey of 200 healthcare consumers who were hospitalized, or who had family members hospitalized in the last two years was conducted during the first week of October 2007. It was commissioned by the Massachusetts Nurses Association, one of the leaders of The Coalition to Protect Massachusetts Patients.

The Patient Safety Act is co-sponsored by State Senator Marc Pacheco (D-Taunton) and State Representative Christine Canavan (D-Brockton).