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Minnesota Registered Nurses Promote Law to Improve Patient Care and Address Health Care Costs
Date:2/25/2008

Staffing for Patient Safety Legislation Essential to Reduce Patient Suffering and Achieve Affordable Health Care

ST. PAUL, Minn., Feb. 25 /PRNewswire-USNewswire/ -- The critical condition of affordable health care today can be addressed with legislation advanced by the Minnesota Nurses Association (MNA). The organization announced today it will champion "Staffing For Patient Safety" legislation that requires all Minnesota hospitals to adhere to maximum patient assignment limits and incorporate clinical nursing judgment in implementing staffing plans. As a condition of licensure, hospitals must establish staffing plans that include direct input from front line nurses and publicly post and report those plans to the Minnesota Department of Health. The proposed legislation follows the release of extensive research and reports that clearly demonstrate that adequate RN staffing produces dramatic cuts in patient mortality, leads to reduced hospital costs and patient lengths of stay, prevents medical errors and helps retain and recruit nurses to the bedside.

"Reforming the health care system is a high priority in the 2008 legislative session and members of the Minnesota Nurses Association are delivering a high touch/high impact solution designed to reduce grief, suffering and cost," said MNA President, Linda Slattengren, RN.

In today's jargon, these consequences are termed "negative outcomes" or "adverse events," but nurses are daily witnesses to patients in pain, lives that are lost and families in crisis, and know much of it preventable because many of them are due to deliberate decisions to inadequately staff a unit. Nurses have come to recognize this crisis is one of priority, planning and resource allocation.

Methods used to make nursing assignments and schedules fail to reflect the significant variations in the care needs of patients. Formulas for assigning nursing staff do not adequately account for patient acuity levels or the intensity of individual nurse patient loads. Admissions, discharges and transfers of patients are rarely factored in when scheduling nurses to work specific units.

A remarkable body of evidence substantiates that inadequate staffing is costly.

-- The Institute of Medicine attributes a staggering 17 billion dollars to the cost of medical errors.

-- The Joint Commission on Accreditation of Health Care Organizations asserts that inadequate staffing precipitated one quarter of all unexpected occurrences that led to patient deaths, injuries or permanent loss of function.

-- A report by Voluntary Hospitals Association determined that organizations with higher turnover rates (21% or more) had a 36 percent higher cost per discharge rate than hospitals with lower turnover rates of 12 percent or less.

Recent surveys conducted by MNA complement the existing research. A telephone survey of 400 members and 400 Minnesota residents was implemented by Anderson, Niebuhr and Associates from June - September, 2007.

For nurses, the MNA poll found that when nurses are forced to work short staffed, three quarters of all RNs say patient care suffers through --

-- delays in following through with orders, assessment

-- critical watching of patients' fragile conditions

-- inadequate time for appropriate delegation and supervision of

non-RNs

The report was also alarming from the patient perspective. Nearly 30% of all residents believe the quality of care that they or a loved one received during hospitalization was negatively affected by an inadequate number of nurses assigned to the care for patients on their unit.

A young father in Thief River Falls gives particular poignancy to the statistics. Chris Bjerken described the dire circumstances surrounding his daughter's birth. "It was 3:00am. I was in the delivery room with a doctor, my wife and newborn daughter - who was choking. She's brand new, struggling to breathe and my wife is bleeding out on the table. The nurses were stretched thin, running from room to room, trying to come in, but they were tending to other patients who may have been in a similar situation themselves. I could have walked into that hospital with a pregnant wife, and walked out with no one."

Nurses and residents show considerable solidarity in their support for a policy solution to the crisis in understaffing. 87% of nurses and 59% of the resident population openly favor legislation addressing maximum patient limits for RNs.

At its "Code Red For Care" Rally on Tuesday, February 26th in the Rotunda of the State Capitol in St. Paul, 1,500 nurses will gather to demonstrate their collective concern and publicly introduce the Staffing for Patient Safety bill. The legislation has bi-partisan backing and is designated by file numbers SF 2742 in the Senate and HF 3042 in the House.

Chief and co-authors are Sen. Sharon Erickson-Ropes, RN (DFL-Winona), Sen. John Marty (DFL-Roseville), Sen. Ellen Anderson (DFL-St. Paul) , Sen. Kathy Sheran RN (DFL-Mankato), Sen. Paul Koering (R-Fort Ripley); Rep. Erin. Murphy RN (DFL-St. Paul), Rep. Patti Fritz LPN (DFL-Faribault), Rep. Paul Thissen (DFL-Mpls.); Rep. Maria Ruud APRN (DFL-Minnetonka), Rep. Jim Davnie (DFL-Mpls), Rep. Karen Clark RN (DFL-Mpls.)

BILL SUMMARY

All Hospitals Must Establish Staffing Plans

Staffing Standards for Patient Safety legislation requires that all hospitals shall develop and implement a staffing plan that includes direct input from nurses.

The Patient Assignment Limit feature is a foundation, and assures Registered Nurses they will never be assigned more patients than what is set forth in the statute. Staffing plans may be further enhanced by local hospital committees to meet unique hospital needs by establishing upwardly-adjustable nurse-to-patient ratios considering:

-- acuity of patients

-- the level and variability of intensity of care to be provided

-- admissions, discharges, and transfers of patients during each shift

-- specialized experience of RNs and consideration of skill mix

-- contextual issues that impact staffing such as architecture, environment and technology.

Enforcement Posting/ Reporting

This legislation will require hospitals to publicly post their staffing plans and report those plans to the Minnesota Department of Health.

Staffing Standards and Health Care Reform

Unlike physicians, medication or equipment, nurses' work is not clearly identified in the health care accounting process. Minnesota's legislation will develop new measures for delineating nurse-sensitive indicators in adverse event reporting. This will help reform reimbursement systems to more adequately reflect nurses' contributions to quality patient outcomes and health care costs.

Uniting nurses in vision and voice since 1905. With 20,000 members, MNA is the leading organization for registered nurses in the Midwest and is among the oldest and largest representatives of RNs for collective bargaining in the nation. MNA is a multi-purpose organization that fosters high standards for nursing education and practice, and works to advance the profession through legislative activity. MNA is a constituent member of the American Nurses Association, the United American Nurses and the AFL-CIO.


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SOURCE Minnesota Nurses Association
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