"Health Reform must include Protecting Patients" by Beth Piknick, RN

On behalf of thousands of nurses and patient advoacates represented by the Coalition to Protect Massachusetts Patients - I am writing to take issue with the recent posts by hospital industry officials that are critical of pending legislation, The Patient Safety Act, which attempts to address a growing patient safety crisis in our state’s hospitals.

On May 22, the state House of Representatives voted by an overwhelming margin (119 – 35) to pass the measure, which would set a safe limit on the number of patients assigned to a nurse at one time, prohibit the dangerous practice of mandatory overtime, while providing initiatives to increase the supply of nurses. Now the bill moves to the Senate.

The bill responds to increased concern over quality care in Massachusetts hospitals as well as evidence linking disease and deaths to poor patient oversight caused by nurses being forced to care for too many patients at one time.

In fact, a study conducted last October of recent patients in Massachusetts found that greater than one third, an estimated 235,000 patients per year, report that their safety was compromised during their hospital stay because their nurse had too many other patients to care for.

Meanwhile, the Massachusetts hospital industry continues to fight the bill at a time when hospital-acquired infections and medical errors are sharply on the rise. For example, the Massachusetts Coalition for the Prevention of Medical Errors estimates that 2,000 people—or six people per day—are dying in Massachusetts because of them every year.

Numerous studies link the rise in hospital-acquired infections and other medical complications to understaffing of nurses. For example, a report published in the July issue of the journal Medical Care found that safe RN staffing levels could reduce hospital acquired infections by 68 percent.

Numerous other studies show that limiting the number of patients a nurse is forced to care for at one time significantly reduces medical errors and improves outcomes for patients. One of the nation’s leading organizations on patient safety, The Agency for Healthcare Research and Quality (AHRQ) examined over 95 studies on nurse staffing ratios and reported that reducing the number of patients a nurse cares for at one time was associated with reduced hospital mortality and reduced adverse patient events.

As Massachusetts Health Care Reform is implemented, every necessary step should be taken to reign in costs and improve the quality of patient care. Controlling costs means improving quality, and safe RN staffing levels have been linked to preventing medical errors and reducing hospital acquired infections, as well as to saving millions of dollars by preventing costly complications and by reducing hospital length’s of stay.

The hospital industry’s reliance on what they call “transparency” as the solution to this crisis is a sham and will have absolutely no impact on this growing patient safety crisis. They tout the posting of nursing staffing plans – with no required standards for those plans – on a web site, arguing that patients can and will self select better staffed hospitals. The problem is most patients can’t choose the hospital they go to and the reality is, while this web site has been in existence for over two years, patients don’t or wont’ use it. A survey of recent patients found that 9 in 10 had not visited this web site or considered using it to make their decision on where they would receive care.

Massachusetts nurses know that improving nurse to patient ratios will save lives, reduce hospital infections, prevent medical errors, and build in more efficient nursing care for all patients. It is too dangerous to leave nurse staffing to chance. It is time to pass this critical legislation and make care safer for all citizens in Massachusetts.

Beth Piknick, RN
President, Massachusetts Nurses Association & Member of the Coalition to Protect Masschusetts Patients