Safe Staffing

Patient Safety Act is Approved by Public Health Committee

02.28.2008

Measure Calls for Safe Limits on Nurses’ Patient Assignments, Prohibits Mandatory Overtime and Includes Initiatives to Increase Nursing Faculty & Nursing Scholarships

BOSTON, Mass. – The 125-member Coalition to Protect Massachusetts Patients applauds the vote today by the joint Committee on Public Health Committee to approve a bill to guarantee safe RN staffing in all Massachusetts hospitals. The measure, The Patient Safety Act, calls upon the Massachusetts Department of Public Health to set safe limits on nurses’ patient assignments, and also prohibits mandatory overtime and includes initiatives to increase nursing faculty and nurse recruitment.

The bill responds to increased concern over quality care in Massachusetts hospitals as well as evidence linking disease and deaths to poor patient oversight caused by nurses being forced to care for too many patients at one time. In recent years medical errors and hospital acquired infections have soared, with the Centers for Disease Control (CDC) now reporting that 2,000 people, or six people per day, are dying in Massachusetts because of them every year. A number of studies link the rise in hospital-acquired infections and other medical complications to understaffing of nurses. A report published in the July issue of the journal Medical Care which found that safe RN staffing levels could reduce hospital acquired infections by 68 percent.

In May 2006, the Massachusetts House of Representatives passed similar legislation by a margin of 133 to 20 but the bill was not taken up by the Senate. The Patient Safety Act: House Bill 2059 is co-sponsored by State Senator Marc Pacheco (D-Taunton) and State Representative Christine Canavan (D-Brockton). "At last, we have movement on H. 2059!," said Rep. Canavan. "I am so pleased that the Joint Committee on Public Health recognizes the merits of this bill as written, and that it has released the compromise bill. Now we must all join together to successfully move H. 2059 through the House and Senate processes. Let’s make this the year we finally reach the Governor’s desk!"

"We commend the Public Health Committee for their favorable vote on this bill and we look forward to a successful vote in the full House," said John McCormack, the co-chair of The Coalition to Protect Massachusetts Patients. "Every day we wait for this bill to be passed, a distressing number of patients in our hospitals are suffering, and many are dying due to a lack of appropriate nursing care." Key components of the bill include the following:

  • The bill directs the Massachusetts Department of Public Health to develop and implement staffing standards and enforceable limits on the number of hospital patients assigned to a registered nurse at any one time
  • The staffing standards would be developed within 12 months of the bill’s passage and be based on scientific research on nurse staffing levels, patient outcomes, expert testimony, and standards of practice for each specialty area.
  • The bill calls for the safe staffing limits to be implemented in all teaching hospitals by 2009, with implementation in all community hospitals by 2011.
  • The bill allows DPH to grant waivers for hospitals in financial distress.
  • The bill provides flexibility in staffing and accounts for patients who require more care. Once established, the staffing levels will be adjusted up or down based on patients needs using a standardized, DPH-approved system for measuring patient needs.
  • The Act will reduce errors caused by fatigue and overwork by prohibiting hospitals from forcing nurses into mandatory overtime. It will also prevent hospital administrators from moving nurses into unfamiliar assignments without proper orientation.
  • The Act prevents the reduction of support services, including services provided by licensed practical nurses, aides and technicians.
  • The bill establishes a number of nurse recruitment initiatives—sought by the hospital industry and supported by the Coalition—to increase the supply of nurses, by providing nursing scholarships and mentorship programs, as well as support for increases in nursing faculty to educate new nurses. It also would create refresher programs to assist nurses in returning to practice at the hospital bedside. A survey of Massachusetts nurses found that more than 65 percent of those not practicing in hospitals would be likely to return if a law providing safe limits was passed. In California, where similar limits have been in place for three years, 80,000 nurses have returned to the bedside.
  • The bill establishes strong consumer protections for safe RN staffing, including a prominent posting of the daily RN staffing standards on each unit.

To date, 125 of the state’s leading health care and patient advocacy groups have endorsed HB 2059 and have joined forces to push for its passage in both the House and Senate. Recent voter surveys indicate that more than 80 percent of the public supports establishing safe staffing limits. The Patient Safety will now move to the Joint Committee on Health Care Finance.

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