|
MASSACHUSETTS NURSE NEWSLETTER ::
November/December 2007
Patient advocates urge passage of H.2059 at State House hearing
New survey reveals a third of patients say they've felt the
effects of understaffing
Armed with new statistics on patients’
increased concern over quality care in Massachusetts
hospitals as well as evidence linking
disease and deaths to poor patient oversight,
hundreds of elderly Massachusetts residents,
mothers and children, nurses, and other
consumer and health-care advocates from
across the state converged on the State House
on October 24 to urge passage of the Patient
Safety Act, H.2059, at a hearing before the Joint
Committee on Health Care. The bill would set
limits on the number of patients a nurse can
be forced to care for at one time.
For more than a decade, bedside nurses in
Massachusetts have been sounding an alarm
that patients are being harmed because nurses
are being forced to care for too many patients
at one time.
Since the bill’s initial introduction, hospital-
acquired infections and medical errors have
soared, with the Centers for Disease Control
(CDC) now reporting that 2,000 people, or 6
people per day, are dying because of them every
year in Massachusetts. Nationally, 2 million
people are harmed by hospital-acquired infection
and medical error, and nearly 100,000 of
them die each year. As of today, more patients are
killed each year by hospital-acquired infections
than by AIDS and breast cancer combined.
A statewide survey conducted by Opinion
Dynamics Corporation (ODC) and released in
conjunction with the Oct. 24 hearing indicates
that more than one-quarter (28 percent) of Massachusetts
hospital patients and their families
say that their safety, or a family member’s safety,
was compromised by nurse understaffing.
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 whose safety is
compromised by a lack of available nurses.
In addition, nearly three-quarters (73 percent)
of past patients agree that the overall
quality of patient care in Massachusetts hospitals
is suffering because nurses are forced
to care for too many patients at once. And
more than one-third (35 percent) of these
past patients and their families say that their
nurse had too many patients to care for during
a recent hospital stay.
“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
stay,” said John McCormack, the co-chair
of the Coalition to Protect Massachusetts
Patients, which comprises more than 120 leading
health-care and consumer organizations.
“My baby daughter, Taylor, died in 2000 at the
age of two in a Boston hospital because she
didn’t get the care she needed. When I carried
her to the hospital morgue, I promised her that
I would fight my hardest so that this wouldn’t
happen to another child.”
The elderly and the parents of young children
have coalesced around the issue of setting safe
limits on nurses’ patient loads because those populations
(seniors and children) are most at risk of
contracting hospital-acquired infections.
John Bennett, president of the Massachusetts
Senior Action Council, is disturbed by the fact
that so many of the state’s elderly are at risk
for injury or harm in the hospital as a result
of understaffing.
“As an older citizen and leader of a grassroots
organization of seniors, I have been continually
hearing complaints from our members about
problems they and their family members have
experienced as a result of nurse understaffing,”
Bennett said. “Members of my own family have
been hospitalized and over the years I have
watched the care they received deteriorate—
not because nurses don’t
care or aren’t working hard,
but precisely because they
are working too hard, running
from patient to patient
doing what they need to do.
The suffering the lack of
nursing care causes is unacceptable.”
A number of studies link
the rise in hospital-acquired
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
hospital acquired infections
by 68 percent.
“The hospital industry’s
mantra every year for more
than a dozen years has
been, ‘Leave it to us to fix
this problem. We know
best’,” said Karen Higgins,
co-chair of The Coalition
to Protect Massachusetts Patients. “While we
have waited for the hospitals to ‘fix it,’ thousands
of patients have died and continue to die
throughout the commonwealth. The time for
waiting is over. The commonwealth’s hospital
patients and their families can’t afford to wait
any longer.”
The Patient Safety Act (H.2059) would
improve hospital conditions by setting a rational,
safe limit on the number of patients a nurse
can be forced to care for at one time, while also
creating initiatives to increase nursing faculty
and nurse recruitment. Similar legislation to set
safe patient limits was passed in California and
was implemented in 2004. Testimony about the
bill’s success in California was presented by a
panel of frontline nurses from California and
by Karin Berntsen, RN, BSN, a California nurse
administrator and one of the nation’s leading
patient safety experts.
Endorsement from national expert
Contradicting assertions by the hospital
industry that the bill is inflexible and the wrong
approach to improving patient safety, Berntsen
testified about the success of the California law
and said that the Patient Safety Act introduced
in Massachusetts is even better than the California
legislation.
Ms. Berntsen, the author of the books The
Patients Guide to Preventing Medical Errors
and Fatal Care, testified that she observes a
“Massachusetts understaffing crisis,” and that
Massachusetts hospitals “approach is counterproductive
and dangerous to patients.”
“One of the nation’s leading organizations
on patient safety, the Agency for Healthcare
Research and Quality, examined over 90 studies
on nurse staffing and reported that reducing
the number of patients a nurse cares for at one
time is associated with reduced hospital mortality
and reduced adverse patient events,“
she said. “Furthermore, the Patient Safety Act
has been well thought out and builds in the
principles of improved safety and efficiency,
including a balanced approach to nurse staffing,
ramping up of the staffing requirements,
and supporting nurse recruiting to assist with
the bedside nursing shortage,” Ms. Berntsen
added. “The legislation is flexible, and promotes
staffing plans that are balanced for all
hospitals,” she concluded.
Questioning the industry’s ‘solutions’
At a time when patient safety is being
increasingly endangered by RN understaffing,
the state’s hospitals continue to post record
profits of nearly a half-billion dollars for the
first six months of 2007—a 35 percent increase
over the previous year’s second quarter profits.
If the trend continues, the hospital industry is
poised to record its third straight year of profits
in excess of $1 billion.
Instead of investing in safer nursing care, the
Massachusetts hospital industry’s response to
the mounting death toll has been to create a
“Patients First” Web site that posts proposed
nurse staffing “plans” with no guarantee that
the staffing plans are accurate, and with no
uniform standard of care that patients can
expect in all hospitals.
The patients who responded to the ODC
survey said the Web site is of little or no value
to them.
Nearly 90 percent of recent hospital patients
report that they did not have the time to
research staffing levels prior to their hospital
visits. In fact, only 14 percent were aware of the
Web site, and only 4 percent used it.
Audrey Heath, a senior from Worcester,
said she was insulted by the assumption
that she would be able to check a Web site
to safeguard her hospital stay. “You think I
have time to look at a Web site when I’m on
my way to the hospital? Most people my age
are in serious condition when they arrive
at the hospital. They’re not thinking about
the internet.”
The Patient Safety Act is co-sponsored by
Sen. Marc Pacheco (D-Taunton) and Rep.
Christine Canavan (D-Brockton).
|
