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Home > Why
a Bill?
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"…hospital
nurse staffing legislation represents a credible approach to
reducing mortality and increasing nurse retention."
Linda
H. Aiken, PhD, RN JAMA, 2002
"I'm
tired of nurses who aren't at the bedside and yet who oppose…bans
on mandatory overtime, minimum nurse— patient staffing ratios,
or public disclosure of these ratios. If you're a staff nurse
and oppose these things, you're probably working at a fine
institution. But too many nurses aren't."
Diana
J. Mason, PhD, RN Editor-in-Chief, American Journal
of Nursing
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We
have a disturbing crisis in
Massachusetts—nurses are being forced to
care for too many patients, and patients are
suffering the consequences in the form of
preventable errors, avoidable
complications, increased lengths of stay
and readmissions.
The Law
Will Protect Patients
Studies
by the most respected scientific and medical researchers affirm the
significance of safe minimum RN-to-patient
ratios for patient safety.
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More
than 195,000 patients die needlessly every year in our
hospitals from a series of
complications directly related to
poor nurse staffing, according to a
study released in May 2004. The
authors attributed the majority of these
deaths to "failure to rescue" (which
refers to nurses' failure to promptly
assess and treat conditions that
develop in a hospital), bedsores, postoperative
sepsis and post-operative
pulmonary embolisms. (HealthGrades,
2004)
- A
survey of patients found that nearly half of recently hospitalized
patients reported their care was
compromised by inadequate RN-to-patient
ratios, and that the majority
of those surveyed supported
legislation to regulate ratios. (National
Consumers League, 2004)
- The
Institute of Medicine of the National Academies of Science reports
that "nurse staffing levels affect
patient outcomes and safety." Insufficient monitoring of
patients, caused by poor working conditions and the assignment
of too few
RNs, increases the likelihood of patient
deaths and injuries at a time when
avoidable medical errors kill up to
98,000 people in U.S. hospitals every
year. (IOM, November 4, 2003)
- Inadequate
staffing precipitated one-fourth of all sentinel events—unexpected occurrences
that led to patient deaths, injuries, or permanent
loss of function—reported to JCAHO,
the Joint Commission on Accreditation
of Hospital Organizations, the past
five years. (JCAHO, August 7, 2002)
- A
New England Journal of Medicine study documented that improved
RN-to-patient ratios reduce rates of pneumonia, urinary infections,
shock, cardiac arrest,
gastrointestinal bleeding, and other
adverse outcomes. (NEJM, May 30,
2002)
- Research in
the Journal of the American Medical Association found
that up to 20,000 patient deaths each
year can be linked to preventable
patient deaths. For each additional
patient assigned to an RN, the
likelihood of death within 30 days
increased by 7 percent. Four
additional patients increased the risk
of death by 31 percent. (JAMA,
October 22, 2002)
- The Massachusetts
Department of Public Health reports medical errors
and complaints at hospitals have
increased by 76 percent in seven
years. (DPH Division of Health Care
Quality, 2003)
- Poorer
hospital nurse staffing is associated with higher rates of
urinary tract infections, postoperative
infections, pneumonia,
pressure ulcers and increased
lengths of stay, while better nurse
staffing is linked to improved patient
outcomes, according to the Agency for
Healthcare Research and Quality.
(AHRQ report, 2001)
- Two-thirds
of bedside nurses in Massachusetts report knowing of
patients who suffered serious
complications as a result of
understaffing. (Opinion Dynamics
Corp., 2003)
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Each
additional patient per nurse was associated with a 7 percent increase
in mortality. The difference between four to six and four to eight
patients per nurse would be accompanied by 14 and 31 percent increases
in mortality.
-Journal of the American
Medical Association (JAMA)–Hospital
Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction
(October
2002)
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The Law
Will End the Nursing Exodus
To make matters
worse, nurses, burned out with high patient loads, are leaving the
bedside. While Massachusetts has the
highest per capita population of nurses in
the country, many staff nurses are no
longer willing to work in situations where
they are unable to provide proper care for
their patients. The research is clear that
the only way to protect patients and to retain
skilled nurses in our hospitals is to
establish safe staffing standards.
- A survey
published in JAMA found that for every patient beyond four
assigned to a nurse resulted in a 15
percent increase in job dissatisfaction
and a 23 percent increase in burnout
for nurses. (JAMA, 2003)
- Sixty-five
percent of Massachusetts nurses surveyed agree with the
statement that working conditions
in hospitals are "brutal" for nurses;
nearly half of Massachusetts' hospital
nurses have considered leaving their
jobs due to poor staffing. (Opinion
Dynamics Corp., 2003)
- According
to the Board of Registration
in Nursing statistics, the population
of registered nurses in Massachusetts
increased by 10 percent between
1992 and 2002, while the number of
hospital beds to be staffed by
RNs decreased by 30 percent.
- While 83 percent
of Massachusetts nurses are working, only 47 percent
are working at the hospital bedside
(below the national average) and
only half of those are working full time.
The two top reasons nurses are leaving
bedside nursing: staffing and
workload. (Colleagues in Caring,
2002)
- A survey of
42,000 Massachusetts nurses found that 42 percent of those
nurses not working in hospitals
would strongly consider returning to bedside
care if safe staffing legislation
were passed. (Opinion Dynamics
Corp., 2003).
- A 2004 survey
of nurses currently working part-time in hospitals
found that 33 percent would
increase their
hours if the bill were to
pass. (Opinion Dynamics Corp., 2003).
The
time has come for Massachusetts to pass common sense legislation
setting safe minimum registered
nurse-to-patient ratios
in hospitals. Safe ratios save
lives…and
they will end the nursing shortage.
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