Patient Safety/Quality of Care
An Act Ensuring Patient Safety – This
legislation would require all Massachusetts hospitals to adhere
to minimum
registered nurse (RN)-to-patient ratios as a condition of licensure
by DPH. The filing of the legislation follows the release of
prominent research studies and reports that clearly demonstrate
that safe
RN staffing produces dramatic cuts in patient mortality and is
a key element in stemming the flood of RNs from Massachusetts hospitals.
A recent study in the Journal of the American Medical Association
(JAMA) shows that for each additional patient assigned to an RN,
there is a 7% increase in the likelihood of death within 30 days
from a complication not present upon admission to the hospital.
The difference between 4 to 6 and 4 to 8 patients per nurse is
accompanied by 14% and 31% increases in mortality respectively.
It is common for RNs in Massachusetts to be assigned 6, 8, and
even up to 10 patients on a given shift, placing thousands of patients
at risk for serious complications and death.
The scientific evidence is clear and overwhelming:
when nurses have too many patients, patients' safety are in
jeopardy. The evidence also makes clear that poor staffing
conditions in Massachusetts
hospitals have caused and are exacerbated by a growing shortage
of nurses willing to work in hospitals," said MNA President Karen
Higgins, RN. "Passage of this legislation is key to improving
care for our patients and to creating conditions that will retain
and
recruit the nurses we need to provide safe patient care."
Nurses are not alone in their desire for minimum
RN-to-patient ratios. Support among the public for this legislation
is strong
in Massachusetts. A poll of Massachusetts residents found that
more than 75% of the public supports legislation regulating RN-to-patient
ratios. Lead Sponsors: Rep. Christine Canavan, RN, Brockton;
Senator Marc Pacheco, Taunton
For more information on the Patient Safety
Act visit the
MNA Safe Ratios Campaign page.
An Act Relative to A Patient's Report
Card of Nursing -
When nurses advocate for improvements in staffing and changes
in skill mix ratios to improve patient care, the industry
claims there
is not data to support these claims. If this data is collected,
facilities have no legal obligation to share it with policy makers
or the public. This bill would mandate that all hospitals, clinics,
long term care facilities and HMOs track and report to the public
annual data regarding staffing levels and skill mix ratios; as
well as nurse-sensitive patient outcomes, such as patient falls,
nosocomio infections, bedsores, patient satisfaction and medical
errors, readmission rates and length of stay. Lead Sponsor:
Rep. Cory Atkins, Concord
An Act To Ensure Safe Medication Administration -
This bill would amend the Controlled Substances Act (Chapter
94C) by mandating that only licensed professionals may administer
Schedule
II - VI medications, thus clarifying and strengthening Chapter
94C. It would reverse regulatory changes which teach and mandate
unlicensed direct care personnel to administer all schedules
of medications in group home settings, after only a 16 hour
course
and state certification. Those who can self administer, have
family or have personal care attendants to aid with self administration
are exempt from the requirements of this legislation. It will
also
be structured to capture medication errors along with other systems,
which collect this information. Lead Sponsor: Senator Marc Pacheco,
Taunton
An Act Relative To Improvements in Private Duty Nursing
Care for Developmentally Disabled Children – Because
of poor compensation, and lack of appropriate training, there
is serious shortage of nurses to provide home care to developmentally
disabled children in the Commonwealth. This bill would improve
the care of children who are developmentally disabled and in
need of home care services by creating a training program for
the care of these children and a stable pool of qualified nurses.
Further, the nurses would be employed by the state and would
also be granted benefits and commensurate salaries in an attempt
to decrease the rapid turnover of providers experienced by these
families. Lead Sponsor: Senator Steve Tolman, Brighton
An Act Relative To A Nurse Deputy Commissioner At the
Department of Public Health – Nursing plays an essential
and distinct role in the safe delivery of health care in the
Commonwealth. This bill would raise the profile of nurses in
the health care policymaking apparatus, by establishing a Director
of Nursing position, responsible for working with the Commissioner
to ensure that nursing-related issues are adequately monitored
and considered as the department carries out its mandate to protect
the public health. Lead Sponsor: Senator Pam Resor, Acton
An Act Relative To A Registered Nurse Seat On The Public
Health Council – The Public Health Council has existed
for decades. The role of the council currently is primarily to
approve certificates of needs for health care facilities and
new regulations in relation to health care delivery. There has
never been a nursing position on the mostly consumer board. There
are a number of physician positions. This bill would create a
nursing position on this important council. Lead Sponsor: Senator
Richard Moore, Uxbridge
An Act Ensuring Safe Patient Handling – An increasing set
of medical research identifies patient injuries, workplace injuries,
career ending situations and increased costs to the health care
system because of unsafe patient handling. This legislation sets
the development and implementation of safe patient handling procedures
and guideline. Lead Sponsor: Representative Jennifer Callahan,
RN, Sutton
Workplace/Economic Issues
An Act Requiring Health Care Employers To Develop And
Implement Programs To Prevent Workplace Violence – This
bill would mandate a comprehensive workplace violence prevention
program, along with counseling program for victims of workplace
violence who work in the delivery of health care. It would also
address the risk of violence and the appropriate retirement compensation
for those professionals who care for these populations in public
sector settings. Lead Sponsor: Senator Jarrett Barrios, Cambridge
An Act Relative to Assault and Battery on Health Care
Providers - The bills amends Massachusetts law to
declare it a felony to assault any health care worker while
such person
is treating or transporting another. The crime shall be punished
by imprisonment in the house of correction for not more than
two and one-half years or by imprisonment in the state prison
for not more than five years, or by a fine of not more then
$5,000, or by both such fine and imprisonment. Lead Sponsor:
Representative Michael Rodriques, Westport
An Act Relative to Group 4 for Health Care Professionals – This
legislation would place those state employed health care professionals
who work with violent or potentially violent populations in Group
4 for the purpose s of their retirement. Group 4 recognizes state
employees who work in dangerous situations. Lead Sponsor: Senator
Brian Joyce, Milton
An Act Relative to Group 2 Employees - Elevates registered
nurses and other health care professionals that are state employees to
a "professional
status" for the purposes of their retirement. They are currently considered "technical
status" in the state system. Lead Sponsor: Representative Edward Connolly,
Everett
An Act Related To Interest Arbitration for Health Care
Professionals – Provides for the use of binding interest
arbitration in the case of a collective bargaining impasse with
the State. The purpose is to expedite the process, ensuring a
fair and objective settlement to contract negotiations. Lead
Sponsor: Senator Thomas McGee, Lynn
An Act to Include Certain Municipal Employees of the Commonwealth
in Group 2 of the Contributory Retirement System for Public Employees – elevates
nurses in municipal employment from a technical position to a
professional position for the purposes of retirement. Lead
Sponsor: Representative Timothy Toomey, Cambridge
An Act Relative to Creating a Difficult to Manage Unit
Within the Department of Mental Health – This legislation
creates a Difficult to Manage Unit for women within the Department
of Mental Health. The Department currently has such a unit for
men. Lead Sponsor: Representative Patricia Haddad, Somerset
Nursing Practice/Profession
An Act Regarding Insurance Equity For Registered Nurse
First Assistants - Filed with the Association of Operating
Room Nurses, Massachusetts Chapter One, this bill creates equity
for RN First Assistants with other paid providers of first
assistant services. It prevents insurance companies from discriminating
and refusing payment for first assistant services when they
are
provided by a Registered Nurse. Lead Sponsor: Representative
David Linsky, Natick
An Act Authorizing The Sale Of "RN" Distinctive
Registration Plates – This bill would create an RN Vanity
License Plate with directed funding to provide scholarships for
nursing with an emphasis on attracting a diverse population to
enter and advance in the nursing profession. Lead Sponsor:
Representative Brian Knuuttila, Gardner
