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Patient
Safety Wins: A Real Compromise on Nurse Staffing
15
hours of negotiation yield important patient safety measures and
protections for hospitals
The highlights
of the compromise bill legislative leaders developed include:
Protects patient safety
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Directs the Massachusetts
Department of Public Health to develop and implement minimum
RN staffing standards and an enforceable limit on the number
of patients assigned to each registered nurse.
-
The
staffing levels would be set by DPH after public hearings and
will be based on scientific research, patient outcomes and expert
testimony.
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Standardized criteria (acuity based patient classification system)
to adjust the nurses’ patient assignment in order to better
meet patient care needs.
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Prohibits the dangerous practice
of mandatory overtime.
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Assures that hospitals cannot
delegate to unlicensed personnel duties which demand nursing
expertise.
- Protects other valuable members of the health
care team by expressly prohibiting “understaffing of other
critical health care workers, including licensed practical nurses
and unlicensed assistive personnel.”
Assures reasonable process for hospitals to
comply
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Financial hardship waiver
process for hospitals
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Ample 'ramp-up' time
to meet the new standards: teaching hospitals 2008, community
hospitals 2010.
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Flexibility in staffing:
Calls on DPH to create a standardized acuity-based patient classification
system, which is a standardized formula for rating the illness
level of patients allowing an objective tool to adjust RN staffing
to meet patient care needs.
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DPH will have oversight
with the ability to investigate and to utilize their discretion
in any non-compliance review process
Ensures a continued strong pipeline
of nurses into the profession
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Creates programs to increase nurse faculty in our schools
of nursing.
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Creates nurse recruitment initiatives to assure a continued
supply of nurses, including nursing scholarships and mentorship
programs.
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Provides for refresher programs to assist nurses who,
with the passage of enforceable limits on patient assignments,
expressed a strong desire in returning to practice at the hospital
bedside.
Everybody wins here; hospitals, nurses,
and most important of all, the patients.
The
23,000 members of the Massachusetts Nurses Association joins
with the 104 member Coalition to Protect Massachusetts Patients
in applauding the efforts of all involved to reach this compromise
and in doing so address this important patient safety issue.
The
compromise addresses the objections expressed by the hospital
industry
| Hospital
industry objections: |
The
compromise bill: |
| Legislators
setting staffing levels. |
Directs
the DPH to undergo a vigorous regulatory process utilizing
research, data, patient outcome information and expert testimony
to develop safe standards and limits. |
| Flexibility. |
Staffing
based on patients needs. |
| Financial
strapped hospitals ability to comply. |
Provides
hospitals in legitimate financial distress a time-limited
waiver process to comply. |
| The
penalty and fine process was too strict. |
Provides
for a prima facia process, reduced fines and discretion
of DPH during non-compliance review. |
| Need
to focus more on recruitment of nurses. |
Includes
nurse faculty and recruitment initiatives put forth by their
own bill. |
| Need to protect
and account for other members of the health care team. |
Prevents “understaffing
of other critical health care workers, including licensed
practical nurses and unlicensed assistive personnel.”
Also includes these workers in the formula
DPH will create to adjust staffing based on patient needs.
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