Earlier this year, U.S. Representative Lois Capps (D-CA), a nurse, introduced bi-partisan legislation allowing nurses to have a safer work environment. Congresswoman Capps, along with U.S. Representative David Joyce (R-OH), introduced the “Registered Nurse Safe Staffing Act of 2013,” HR 1821. The bill is currently in discussion with the Committee on Energy and Commerce and is also being read at the Committee on Ways and Means.
The primary goal of the bill is to provide for patient protection by establishing safe nurse staffing levels at certain Medicare providers. The bill enumerates many well known facts about workplace safety for nurses, patients, and hospitals. Some include:
- Research shows that patient safety in hospitals is directly proportionate to the number of RNs working in the hospital. Higher staffing levels by experienced RNs are related to lower rates of negative patient outcomes.
- A 2011 study on nurse staffing and inpatient hospital mortality shows that sub-optimal nurse staffing is linked with a greater likelihood of patient death in the hospital. A 2012 study of serious patient events reported to the Joint Commission demonstrates that one of the leading causes of all hospital sentinel events is human factors, including staffing and staffing skill mix.
- Healthcare worker fatigue has been identified as a major patient safety hazard, and appropriate staffing policies and practices are indicated as an effective strategy to reduce healthcare worker fatigue and to protect patients. A national survey of RNs found that 74% experience acute or chronic effects of stress and overwork.
- A 2012 study of Pennsylvania hospitals shows that by reducing nurse burnout, which is attributed in part to poor nurse staffing, those hospitals could prevent an estimated 4,160 infections with an associated savings of $41,000,000. That study also found that for each additional patient assigned to an RN for care, there is an incidence of roughly one additional catheter-acquired urinary tract infection per 1,000 patients, or 1,351 infections per year, costing those hospitals as much as $1,100,000 annually.
- When hospitals employ insufficient numbers of nursing staff, RNs are being required to perform professional services under conditions that do not support quality health care or a healthful work environment for RNs.
The bill also establishes certain levels of safety for nurse staffing at Medicare participating hospitals. Each participating hospital shall implement a hospital-wide staffing plan for nursing services furnished in the hospital, through which a nursing staff committee will help develop.
The inclusive committee will “conduct regular, ongoing monitoring of the implementation of the hospital-wide staffing plan for nursing services furnished in the hospital; carry out evaluations of the hospital-wide staffing plan for nursing services at least annually; and make such modifications to the hospital-wide staffing plan for nursing services as may be appropriate.”
There is yet to be a companion bill in the U.S. Senate, but as the bill moves forward, ONS will keep its members apprised of the legislation.