MNA Cites Report as Evidence of Positive Impact Nurses Have on Patient Care and the Need for Policies to Increase RN Staffing and Regulate Registered Nurse to Patient Ratios
CANTON, Mass. — Inadequate registered nurse staffing in America’s hospitals and a growing shortage of nurses poses a serious health risk for hospital patients, according to a report released today by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The report states that inadequate staffing levels have been a factor in nearly a quarter of most serious life-threatening events that have been reported to the Commission in the last five years.
The JCAHO report analyzed more than 1,600 serious incidents from 1996 through March 2002 and found that nurse staffing levels were deemed a contributing factor in 50% of ventilator-related incidents, 42% of surgery-related incidents, 25% of transfusion incidents, 25% of delays in treatment, 25% of infant abductions, 19% of medication errors, 14% of inpatient suicides, and 14% of patient falls.
The study follows on the heels of a recent study published in the New England Journal of Medicine that showed that poor registered nurse staffing levels causes a number of patient complications and may cause thousands of deaths each year.
According to the JCAHO report, "When there are too few nurses, patient safety is threatened and health care quality is severely compromised. The impending crisis in nurse staffing has the potential to impact the very health and security of our society if definitive steps are not taken to address its underlying causes."
"This report validate what the Massachusetts Nurses Association and thousands of nurses across the Commonwealth have been saying for more than seven years – nurses are the key to quality care in our hospitals and chronic understaffing conditions are harming patients and driving thousands of nurses away from the hospital bedside," said Karen Higgins, President of the MNA, the Canton-based professional association and the state’s largest union of registered nurses. "It also underscores the need to pass legislation to regulate RN to patient ratios, which is the key to guaranteeing safe care to patients."
For years, the MNA has been raising concerns about the negative impact of dramatic cutbacks in nurse staffing levels at Massachusetts health care facilities.
"The health care industry, with JCAHO serving as the industry watchdog the entire time, deliberately created the working conditions that have led to the shortage we now face," said Higgins. "Throughout the 1990’s, when there was no shortage of nurses, hospitals laid off thousands of nurses and replaced thousands more with lesser qualified, unlicensed personnel as a cost cutting measure in response to managed care."
In the last decade, nurses’ patient assignments have doubled and sometimes tripled. When nurses should be caring for no more than 4 or 5 patients, today they are often expected to care for 7, 8, 9 or even 12 patients.
According to the MNA, and supported by recent nursing research, these staffing conditions have driven thousands of nurses to leave the hospital bedside to pursue other types of nursing, or to leave nursing altogether. According to one national study, one if five nurses overall is planning to leave the profession in the next year, and one in three nurses under 30 is planning to quit in the next year, primarily due to staffing conditions.
This summer, a coalition of nursing and health care organizations completed a statewide survey of Massachusetts nurses which confirmed that while 81 percent of nurses in Massachusetts are working, only 46% are working at the hospital bedside, and only half of those nurses are working full time. Nurses who have left the bedside cited staffing levels and excessive workloads as the top two reasons for their decision to quit.
The JCAHO report includes a number of recommendations as a call to action for the health care industry to deal with the crisis including: transforming the nursing workplace; creating a clinical foundation for nursing educational preparation and advancement; and providing financial incentives for health care organizations to invest in high quality nursing care.
While the MNA acknowledges that the Commission’s suggestions might help the situation, the proposed remedies fail to address the underlying cause of the current shortage, nor do they provide the ultimate solution to the current crisis.
The ultimate solution to the current crisis, according to the MNA, lies in passing legislation, similar to a new law in California, that regulates registered nurse to patient ratios for health care facilities.
"What policymakers need to understand is that we don’t have a shortage of nurses in Massachusetts. In fact, Massachusetts has the highest per capita population of nurses in the nation. What we have is a shortage of nurses willing to practice with the current staffing ratios. If we give nurses a safe number of patients to care for, nurses will stay, and more importantly, more nurses will come back to the bedside."