CANTON, Mass. — In the wake of the release last week of a report by the Department of Public Health (DPH) showing a 76 percent increase in the number of injuries and complaints by patients in Massachusetts hospitals, a strong majority of Massachusetts residents link the decline in quality of care to the issue of understaffing of registered nurses and inadequate RN-to-patient ratios, according to a recent omnibus statewide survey conducted by Opinion Dynamics Corporation (ODC) of Cambridge, Massachusetts.
Most telling in the survey is the significant impact that the issue could have on voters at the ballot box. When asked if a candidate’s position on safe RN staffing legislation (House 1282) would have an impact on their vote at the ballot box, an overwhelming 60 percent of respondents said they would be "more likely" to vote for a candidate that supports the legislation. Forty-five percent of respondents say that they would be "much more likely" to support a candidate that favored the safe RN staffing legislation.
The results of the October 2003 survey indicate that the public’s awareness and concern for patient safety and quality care rose significantly. Sixty percent of respondents say that they "agree strongly" that patients are suffering because they have to share their nurse with too many other patients as a result of inappropriate cost cutting. This is a jump from 49 percent last year.
The survey also found that public support in the Commonwealth for legislation setting minimum safe RN-to-patient ratios continues to grow, with 61 percent now "strongly" – the highest category of support in the survey – in favor of it, compared to 58 percent strongly in favor last year. Overall support for the legislation remains overwhelming, with 76 percent of respondents in favor of the bill.
Uniquely, the results remained consistent across ideological, age, gender, and party affiliation.
"This is a clear patient safety issue for voters" said John Gorman, president of ODC. "The attitude of the majority of voters on the issue is particularly striking. Most issues either polarize the electorate or don’t have an impact on how they will vote. The safe staffing issue has consistent support across the electorate and could clearly influence voters’ choices."
Earlier surveys established that nurses receive the highest job ratings of all hospital employees and are perceived as having the most significant impact on the quality of patient care, above doctors and other hospital personnel.
The DPH report cites instances of medical error, patient falls and other incidents that have been clearly linked to understaffing. A report by the Joint Commission on the Accreditation of Health Care Organizations (JCAHO) clearly established that increases in these and other patient injuries were due to understaffing of registered nurses.
In June 2003, an independent study of registered nurses in Massachusetts found that poor RN-to-patient ratios are resulting in significant harm and even death for patients. According to the survey, 87 percent of nurses reported having too many patients to care for, with devastating results for patients:
Alarmingly, nearly one in three nurses (29 percent) reported patient deaths directly attributable to having too many patients to care for;
- 67 percent reported an increase in medication errors due to understaffing;
- 64 percent reported an increase in complications due to understaffing;
- 54 percent reported readmission of patients due to understaffing;
- 52 percent reported injury and harm to patients do to understaffing;
- 1 in 2 nurses reported that poor staffing leads to longer stays for patients, which cost more; and
- Only 4 percent of registered nurses report that patient care in their hospitals is excellent.
H.1282, which aims to mandate minimum RN-to-patient ratios in all acute care hospitals in Massachusetts, was developed in response to studies by the New England Journal of Medicine, The Journal of the American Medical Association, JCAHO, and other prestigious researchers revealing that the more patients a registered nurse cares for, the higher the risk of injury, illness and mortality to those patients.
The safe staffing bill was filed by Rep. Christine Canavan (D-Brockton) and the MNA. It is co-sponsored by 101 out of 200 members of the Legislature, including 14 of the 17 members of the Joint Committee on Health Care.
In addition to legislative support, the bill has garnered strong support from 64 health care and consumer advocacy groups that have joined forces with Bay State RNs to form the Coalition to Protect Massachusetts Patients, which will push for the urgently needed measure to safeguard hospital patients. Information about the Coalition and the safe staffing legislation can be found at www.protectmasspatients.org.
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