Wednesday, October 29, 2008
Comments
All of the comments we have received have unanimously supported our stance on the Registered Nurse Safe Staffing Act. In the future we hope that more people will view our blog to understand the importance of this legislation. For more information in support of our Bill on a larger scale you can visit the American Nurses Association's website at http://www.nursingworld.org/.
Tuesday, October 14, 2008
Stakeholders and Action Plan
Key Stakeholders:
The legislator for the bill is Democrat Daniel Inouye from Hawaii, who identified the needs addressed by the bill and drew the bill up.
Key stakeholders and legislators for the bill include patients, nurses, other health care staff, taxpayers, and hospitals. The patients, nurses, other health care staff, and taxpayers all stand to gain from passing this legislation. There will be safer standards set in place for patients, who will receive higher quality health care from nurses. Nurses will be less overwhelmed, less prone to medical errors, more able to meet patients' comprehensive demands, and able to improve every aspect of their care on each patient. Other health care staff will also be able to meet demands more effectively because nurses will be able to carry out orders and delegate tasks more responsibly and consistently. Finally, taxpayers stand to benefit from this bill as well, in that they will receive better health care overall, which lowers health care costs. The hospitals may resist the bill only because it requires them to add multiple new salaries to their payroll in terms of meeting a quota of nursing jobs. However, hospitals also stand to gain credibility from the bill because the reputation of the hospitals will improve with better standardized care levels, attracting more patients to their facility and making better business for them.
Stance: We are in SUPPORT of the Registered Nurse Safe Staffing Act of 2007
Why?
To:
- ADVOCATE for other nurses, the patients, and the hospital facilities
- Create new nursing jobs
- Reduce nurse dissatisfaction in jobs
- Increase patient safety and "reduce this public health crisis"
- Reduce the cost to treat hospital acquired complications
- Clearly communicate with patients through hospital postings the number of staff involved in the care on their floor
- Reduce staff system discrepencies based on the type of payer (ANA, 2008)
- Ensure consistency of quality of care and ensuring the "nurse's worklife is appropriate (ANA, 2008)"
Political Action Plan:
Our political action plan includes to encourage current and future nurses, health care professionals, and patients, family, and friends to write to their senators, requesting more attention and focus on passing the bill. You can also visit the ANA's website and read more about how safe staffing saves lives. We also must encourage everyone to stay involved in the news and in getting this bill passed. We will keep the blog updated and respond to anyone who asks us questions about the bill so that accurate information can be disseminated and goals can be created by our blog community.
Armstrong, F (2006). Safe staffing saves lives. Australian Nursing Journal, 13(10), 22.
ANA (2008). ANA principles on safe nurse staffing. American Nurses Association.
Retrieved from http://www.safestaffingsaveslives.org/ on October 14, 2008.
McCoy, K. (2007). More hospital nurses mean fewer infections. HealthDay ConsumerNews
Service.
South Carolina Nurses Association (2008). ANA launches safe staffing activities: What are the
ANA safe staffing principles? The South Carolina Nurse, 15(3), 1-2.
The legislator for the bill is Democrat Daniel Inouye from Hawaii, who identified the needs addressed by the bill and drew the bill up.
Key stakeholders and legislators for the bill include patients, nurses, other health care staff, taxpayers, and hospitals. The patients, nurses, other health care staff, and taxpayers all stand to gain from passing this legislation. There will be safer standards set in place for patients, who will receive higher quality health care from nurses. Nurses will be less overwhelmed, less prone to medical errors, more able to meet patients' comprehensive demands, and able to improve every aspect of their care on each patient. Other health care staff will also be able to meet demands more effectively because nurses will be able to carry out orders and delegate tasks more responsibly and consistently. Finally, taxpayers stand to benefit from this bill as well, in that they will receive better health care overall, which lowers health care costs. The hospitals may resist the bill only because it requires them to add multiple new salaries to their payroll in terms of meeting a quota of nursing jobs. However, hospitals also stand to gain credibility from the bill because the reputation of the hospitals will improve with better standardized care levels, attracting more patients to their facility and making better business for them.
Stance: We are in SUPPORT of the Registered Nurse Safe Staffing Act of 2007
Why?
To:
- ADVOCATE for other nurses, the patients, and the hospital facilities
- Create new nursing jobs
- Reduce nurse dissatisfaction in jobs
- 73 % of nurses do not feel the staffing on their unit is sufficient (South Carolina Nurses Association, 2008)
- Increase patient safety and "reduce this public health crisis"
- A study in Australia identified 18,000 hospital deaths that could have been prevented with higher nurse staffing (Armstrong, 2006)
- Reduce the cost to treat hospital acquired complications
- As mentioned in the previous blog post, there is a correlation between higher nurse staffing and lower rates of VAP (McCoy 2007)
- Clearly communicate with patients through hospital postings the number of staff involved in the care on their floor
- Reduce staff system discrepencies based on the type of payer (ANA, 2008)
- Ensure consistency of quality of care and ensuring the "nurse's worklife is appropriate (ANA, 2008)"
Political Action Plan:
Our political action plan includes to encourage current and future nurses, health care professionals, and patients, family, and friends to write to their senators, requesting more attention and focus on passing the bill. You can also visit the ANA's website and read more about how safe staffing saves lives. We also must encourage everyone to stay involved in the news and in getting this bill passed. We will keep the blog updated and respond to anyone who asks us questions about the bill so that accurate information can be disseminated and goals can be created by our blog community.
Armstrong, F (2006). Safe staffing saves lives. Australian Nursing Journal, 13(10), 22.
ANA (2008). ANA principles on safe nurse staffing. American Nurses Association.
Retrieved from http://www.safestaffingsaveslives.org/ on October 14, 2008.
McCoy, K. (2007). More hospital nurses mean fewer infections. HealthDay ConsumerNews
Service.
South Carolina Nurses Association (2008). ANA launches safe staffing activities: What are the
ANA safe staffing principles? The South Carolina Nurse, 15(3), 1-2.
Tuesday, October 7, 2008
Scholarly Evidence
Governmental Objectives:
-- Creation of new nursing jobs.
-- Improvement of nurses ability to deliver proper levels of care.
-- Improved patient outcomes.
-- Ensuring lower costs to the hospital and patient by reducing nursing errors due to understaffing.
Political Influences:
-- Placing more regulation on hospitals in order to make them conform to realistic individual patient needs.
-- Setting a precedent that government regulations play a larger role in and have expanded powers over hospitals.
-- Creating a penal system for hospitals that get fined if they do not abide, while also creating a population of evaluators who ensure that hospitals are abiding to this bill.
How it affects the client:
A client is safer the more nurses there are on staff
A study completed by Aiken et al focused on the relationship between patient-to-nurse ratios and patient mortality. They found out that each additional patient a nurse was supposed to look after resulted in a 7% increase in the failure of the nurse to rescue that patient (Garrett, 2008).
How it affects the nurses:
Short staffing furthers nurse fatigue and occupational dissatisfaction
Poll of more than ten thousand nurses nationwide:
73% of nurses asked don’t believe the staffing on their unit or shift is sufficient.
59.8% of those asked said they knew of someone who left direct care nursing due to concerns about safe staffing.
48.2% would not feel confident having someone close to them receiving care in the facility where they work (South Carolina Nurses Association, 2008).
How it affects the health care system:
When the nurse-to-patient ratio is lowered, hospital acquired complications are reduced, thereby reducing costs.
Ventilator-associated pneumonia (VAP) is more likely to develop on a vent patient when there are fewer nurses on duty. The cost to treat a 10-day ventilator patient would increase from $10,000 to $40,000 if the patient were to develop VAP (McCoy, 2007).
Garrett, C. (2008). The effect of nurse staffing patterns on medical errors and nurse burnout. AORN, 87(6), 1191-1204.
McCoy, K. (2007). More hospital nurses mean fewer infections. HealthDay Consumer
News Service.
South Carolina Nurses Association (2008). ANA launches safe staffing activities: What are the ANA safe staffing principles? The South Carolina Nurse, 15(3), 1-2.
-- Creation of new nursing jobs.
-- Improvement of nurses ability to deliver proper levels of care.
-- Improved patient outcomes.
-- Ensuring lower costs to the hospital and patient by reducing nursing errors due to understaffing.
Political Influences:
-- Placing more regulation on hospitals in order to make them conform to realistic individual patient needs.
-- Setting a precedent that government regulations play a larger role in and have expanded powers over hospitals.
-- Creating a penal system for hospitals that get fined if they do not abide, while also creating a population of evaluators who ensure that hospitals are abiding to this bill.
How it affects the client:
A client is safer the more nurses there are on staff
A study completed by Aiken et al focused on the relationship between patient-to-nurse ratios and patient mortality. They found out that each additional patient a nurse was supposed to look after resulted in a 7% increase in the failure of the nurse to rescue that patient (Garrett, 2008).
How it affects the nurses:
Short staffing furthers nurse fatigue and occupational dissatisfaction
Poll of more than ten thousand nurses nationwide:
73% of nurses asked don’t believe the staffing on their unit or shift is sufficient.
59.8% of those asked said they knew of someone who left direct care nursing due to concerns about safe staffing.
48.2% would not feel confident having someone close to them receiving care in the facility where they work (South Carolina Nurses Association, 2008).
How it affects the health care system:
When the nurse-to-patient ratio is lowered, hospital acquired complications are reduced, thereby reducing costs.
Ventilator-associated pneumonia (VAP) is more likely to develop on a vent patient when there are fewer nurses on duty. The cost to treat a 10-day ventilator patient would increase from $10,000 to $40,000 if the patient were to develop VAP (McCoy, 2007).
Garrett, C. (2008). The effect of nurse staffing patterns on medical errors and nurse burnout. AORN, 87(6), 1191-1204.
McCoy, K. (2007). More hospital nurses mean fewer infections. HealthDay Consumer
News Service.
South Carolina Nurses Association (2008). ANA launches safe staffing activities: What are the ANA safe staffing principles? The South Carolina Nurse, 15(3), 1-2.
Tuesday, September 30, 2008
Need for Change
Description of the Bill
The goal of the Registered Nurse Safe Staffing Act of 2007 is "To amend title XVIII of the Social Security Act to provide for patient protection by establishing minimum nurse staffing ratios at certain Medicare providers, and for other purposes."
The problem identified in Congress is that "There are hospitals throughout the United States that have inadequate staffing of registered nurses to protect the well-being and health of the patients" The target population of hospitals to come into compliance is any federally funded (Medicare) hospital.
Things required for new formulation of nursing staff minimal requirements include:
-- Nurse input.
-- Have the staffing numbers required to perform more demanding patient care, such as acutely ill patients, admissions, discharges, etc.
--Acknowledgement of the disparities of geographical and technological supplies within various hospitals and allowance of the potential excess time required to access these materials.
--Acknowledge staffing shortages in other closely-related disciplines and their affects on nursing demand.
--Give nurses the power to examine a patient's medical needs and request staffing accordingly.
--Place nurses in an area of care that they feel adequately trained to provide safely.
--Strive for accurate feedback to ensure accurate nursing staffing.
--Hospitals will not be allowed to cap the number of nurses requested by nursing staff if warranted by patient condition.
-- Hospitals will keep public and overseeing governmental bodies aware of hospital records of published regarding registered nursing staff patient ratios.
-- The hospital must maintain current evaluation no older than one year of the required registered nurse-to-patient ratio.
--The newly created role of the Secretary in these hospitals will be to record and publish the data collected about registered nurse-to-patient ratios. If a person files a complaint with the level of care provided related to short staffing, the hospital may be fined and the Secretary will make note of it and publish the complaint and fine on a public website. The hospitals may not retaliate against any nurse or patient that claims that the hospital has not acted appropriately.
The goal of the Registered Nurse Safe Staffing Act of 2007 is "To amend title XVIII of the Social Security Act to provide for patient protection by establishing minimum nurse staffing ratios at certain Medicare providers, and for other purposes."
The problem identified in Congress is that "There are hospitals throughout the United States that have inadequate staffing of registered nurses to protect the well-being and health of the patients" The target population of hospitals to come into compliance is any federally funded (Medicare) hospital.
Things required for new formulation of nursing staff minimal requirements include:
-- Nurse input.
-- Have the staffing numbers required to perform more demanding patient care, such as acutely ill patients, admissions, discharges, etc.
--Acknowledgement of the disparities of geographical and technological supplies within various hospitals and allowance of the potential excess time required to access these materials.
--Acknowledge staffing shortages in other closely-related disciplines and their affects on nursing demand.
--Give nurses the power to examine a patient's medical needs and request staffing accordingly.
--Place nurses in an area of care that they feel adequately trained to provide safely.
--Strive for accurate feedback to ensure accurate nursing staffing.
--Hospitals will not be allowed to cap the number of nurses requested by nursing staff if warranted by patient condition.
-- Hospitals will keep public and overseeing governmental bodies aware of hospital records of published regarding registered nursing staff patient ratios.
-- The hospital must maintain current evaluation no older than one year of the required registered nurse-to-patient ratio.
--The newly created role of the Secretary in these hospitals will be to record and publish the data collected about registered nurse-to-patient ratios. If a person files a complaint with the level of care provided related to short staffing, the hospital may be fined and the Secretary will make note of it and publish the complaint and fine on a public website. The hospitals may not retaliate against any nurse or patient that claims that the hospital has not acted appropriately.
Sponsor: Daniel K Inouye-D, Hawaii
Need for Policy Change
Inadequate staffing has an adverse effect on both patients and nurses. Quality of nursing care has been shown to decline with understaffing, and a patient’s health directly correlates with the number of registered nurse (RN) employees. This is an increasing problem because there is a severe shortage of and growing demand for RNs in the United States. The shortage of RNs is expected to reach 500,000 by 2025 according to Dr. Peter Buerhaus in a March 2008 report titled The Future of the Nursing Workforce in the United States: Data, Trends, and Implications (http://www.aacn.nche.edu/Media/FactSheets/NursingShortage.htm). The Federal Government will pay less money in Medicare reimbursements through decreasing the nurse to patient ratio because patient safety is better protected and fewer errors in care will occur while patients are in the hospital. If bill S.73 is passed, the decreased nurse to patient ratio will improve patient’s safety, promote a more positive work environment for RNs, and save money through reducing the number of hospital related errors and illnesses.
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