Safe Staffing

Nurses, Patient Advocates and Legislators Rally at State House for Patient Safety Full House Vote on Patient Safety Act Scheduled for May 21 or 22

05.06.2008

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

BOSTON, Mass.—Nearly 1000 nurses, patient advocates and legislators rallied at the State House today, National Nurses Day, in support of The Patient Safety Act. The rally came after the announcement that House Speaker Sal DiMasi has scheduled a vote on the bill for May 21 or 22.

Last week, the Joint Committee on Health Care Financing voted to approve the bill, which would guarantee Massachusetts patients safe RN staffing in all 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 Committee voted 15 – 3 in favor of the measure, which now moves onto the House Ways and Means Committee.

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. Numerous studies link the rise in hospital-acquired infections and other medical complications to understaffing of nurses. For example, a report published in the July issue of the journal Medical Care found that safe RN staffing levels could reduce hospital acquired infections by 68 percent.

Meanwhile, the Massachusetts hospital industry continues to fight the bill at a time when hospital-acquired infections and medical errors are sharply on the rise. For example, the Massachusetts Coalition for the Prevention of Medical Errors estimates that 2,000 people—or six people per day—are dying in Massachusetts because of them every year.

In May 2006, the Massachusetts House of Representatives passed an earlier version of The Patient Safety Act by a margin of 133 to 20 but the bill was not taken up by the Senate. The bill is co-sponsored by State Representative Christine Canavan (D-Brockton) and State Senator Marc Pacheco (D-Taunton). “At last, we have movement on the Patient Safety Act,” said Rep. Canavan. “I am so pleased that the House leadership recognizes the merits of this bill. Let’s make this the year we finally reach the Governor’s desk!”

“We applaud Speaker DiMasi for scheduling a vote on The Patient Safety Act.” 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 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, 130 of the state’s leading health care and patient advocacy groups have endorsed the Patient Safety Act 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.