News & Events

Health Policy Commission to Hold Hearings (March 25 in Boston and April 2 in Worcester) on Recently Enacted Law Mandating Safe Patient Limits for Nurses Working in Mass. Hospital ICUs

Seeks Nurses’ Input on Draft Regulations Addressing Specific Aspects
of the Law Including a Process for Developing a Tool to Assist Nurses
in Determining a Safe Patient Assignment

Nurses, along with other advocates, will be on hand to push for clear language that prevents hospitals from skirting the law and endangering patients

Wednesday, March 25 at 12 noon, One Ashburton Place, 21st Floor, Boston
Thursday, April 2 at 10 a.m., Worcester State University, Blue Lounge, 48 Chandler St., Worcester

What:    On September 28, 2014 a new law went into effect that requires hospitals to adhere to safer patient limits for registered nurses who care for patients in all Massachusetts hospital intensive care units. The law ensures that no nurse can take more than one patient, with the ability to move to a two-patient assignment based on the stability of the patients as assessed by the direct care nurses, not managers or administrators, with the assistance of a soon to be developed “acuity tool” (a tool used to identify and measure specific clinical and environmental factors that determine how stable a patient is and the amount of care required). 

Representatives from the Massachusetts Nurses Association, along with other health care and consumer advocacy groups will be among those testifying on March 25 and April 2, when the Health Policy Commission will hold  public hearings to assist the Commission in finalizing and clarifying “draft” regulations governing the implementation of the new law, including: the process governing the formulation of an acuity tool, the method of public reporting of staffing compliance, and identifying three to five patient safety quality indicators to be measured and reported by hospitals.

The MNA has serious concerns about the “draft” regulations and nurses will be at the hearing to advocate for needed changes to ensure the intent of the law is followed. Specifically, the regulations fail to make clear that the baseline staffing assignment for any ICU nurse is one nurse to one patient, which is the clear intent of the law.  This is important as the Massachusetts Hospital Association and a number of its hospitals have been engaged in an effort to undermine the law and many hospitals have been violating the law on a regular basis, forcing nurse to take two and even three patients at a time. The regulations also fail to follow the strong recommendations of MNA regarding the need for the HPC to be prescriptive in delineating specific clinical conditions for ICU patients that would prevent a nurse taking on a second patient. Instead, the regulations stipulate a process whereby individual hospitals will form “Advisory Committees” to develop a hospital specific acuity tool, which would then be submitted to DPH to be certified for use at the hospital. The problem is the regulations do not ensure that the committees be comprised of a majority of ICU staff nurses. These committees are purely advisory, and upper management retains the right to submit the final tool to DPH. The MNA opposes any process that grants hospital administrators, rather than the direct care registered nurse, the authority to determine the patient’s  acuity, and thereby the staffing level at a hospital. If approved and made final, these regulations could result in situations where a patient with the same condition could receive a different level of nursing care depending on which hospital they are admitted to, based on the different acuity tools developed by each hospital administration. This is precisely the problem the law was created to prevent.

Click here to review the draft regulations, which include notes by MNA of areas that need to be changed.