Daily Archives: May 13, 2013

05.13.13
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RN Safe Staffing Bill

The American Nurses Association (ANA) applauds the introduction of federal legislation that empowers registered nurses (RNs) to drive staffing decisions in hospitals and, consequently, protect patients and improve the quality of care.

The Registered Nurse Safe Staffing Act of 2013 (H.R. 1821), crafted with input from ANA, has sponsors from both political parties who co-chair the House Nursing Caucus – Reps. David Joyce (R-OH) and Lois Capps (D-CA), a nurse.

“Nurse staffing has a direct impact on patient safety. We know that when there are appropriate nurse staffing levels, patient outcomes improve. Determining the appropriate number and mix of nursing staff is critical to the delivery of quality patient care,” said ANA President Karen A. Daley, PhD, RN, FAAN. “Federal legislation is necessary to increase protections for patients and ensure fair working conditions for nurses.”

Research has shown that higher staffing levels by experienced RNs are linked to lower rates of patient falls, infections, medication errors, and even death.

And when unanticipated events happen in a hospital resulting in patient death, injury, or permanent loss of function, inadequate nurse staffing often is cited as a contributing factor.

The bill would require hospitals to establish committees that would create unit-by-unit nurse staffing plans based on multiple factors, such as the number of patients on the unit, severity of the patients’ conditions, experience and skill level of the RNs, availability of support staff, and technological resources.

The safe staffing bill also would require hospitals that participate in Medicare to publicly report nurse staffing plans for each unit. It would place limits on the practice of “floating” nurses by ensuring that RNs are not forced to work on units if they lack the education and experience in that specialty. It also would hold hospitals accountable for safe nurse staffing by requiring the development of procedures for receiving and investigating complaints; allowing imposition of civil monetary penalties for knowing violations; and providing whistle-blower protections for those who file a complaint about staffing.

ANA backed a similar staffing bill in the last Congress. This version includes requirements that a hospital’s staffing committee be comprised of at least 55 percent direct care nurses or their representatives, and that the staffing plans must establish adjustable minimum nurse-to-patient ratios.

Additionally, ANA has advocated for safe staffing conditions for the nation’s RNs through the development and updating of ANA’s Principles for Nurse Staffing, and implementation of a national nursing quality database program that correlates staffing to patient outcomes.

To date, seven states have passed nurse safe staffing legislation that closely resembles ANA’s recommended approach to ensure safe staffing, utilizing a hospital-wide staffing committee in which direct care nurses have a voice in creating the appropriate staffing levels. Those states are Connecticut, Illinois, Nevada, Ohio, Oregon, Texas, and Washington.

For more information on ANA’s safe staffing legislative efforts, please visit www.RNAction.org.

05.13.13
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MNA NewsScan, May 13, 2013: Fund set for RNs, colleagues lost in limo fire; ND highest in worker death

NOTES ON NURSING

Angels Fund Set Up for RNs and Co-Workers Lost in Limo Fire   This year’s Nurses Week was sadly darkened by the death of two RNs and three other caregivers in a tragic limousine fire on the San Mateo Bridge in the San Francisco Bay Area.

UMass Nurses Will Strike Over Poor Patient Care Conditions    After posting more than $88 million in profits, UMass Memorial Medical Center has slashed its nursing and support staff in the last two years.

LABOR UPDATES

Dairy Queen Offers Grads Their First Job – Without Pay    Edina-based Dairy Queen is giving new college grads the chance to shill for its Orange Julius brand.

North Dakota Leads Nation in Rate of Worker Deaths   North Dakota had a workplace fatality rate that was more than three times greater than the national average and more than five times greater than Minnesota’s rate.

HEALTH CARE

Health Care Plan Needed for End of Life   Never in human existence has dying been more complicated. Before the onset of modern medicine, most people died quickly from an acute event such as trauma or the effects of infection. Today most deaths are a slow process of decline.

The Skyhigh Price of Chemotherapy:  Why Do Cancer Drugs Cost So Much?  Overall, cancer drug prices are skyrocketing. Of the 12 drugs approved by the Food and Drug Administration for various cancer conditions in 2012, 11 were priced above $100,000 for a year of treatment.

Study:  Nearly One-Third of All Death Certificates Are Wrong   As to why doctors were reporting inaccurate causes of death, it actually appears to be a weirdly bureaucratic reason: Three-quarters said the system they use in New York City would not accept what they thought to be the real cause of death.

05.13.13
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Is it a Destination or a Theme Park?

The Mayo’s Destination Medical Center appears to be a done deal.  Hundreds of milliions of taxpayer dollars will transform Rochester into a gilded city worthy of hosting a gold standard of health care in the world, but something’s missing from all the talk – patients.

We know a little about what Rochester could look like, but it’s a lot more than we know what the Mayo could look like.  Rochester is slated to build new bridges, hotels, streets, and even a high-speed train from Minneapolis.   The DMC will create the optimal experience for patients and their families with world-class amenities to match their level of care.  That means hotels, restaurants, where patients and/or their families could enjoy lavish accommodations and entertainment while getting better.

In fact, both Minnesota Public Radio and the Rochester Post-Bulletin have reported that for more than two years, DMC was a top-secret project.  No one in the newspaper’s newsroom had even heard of the DMC, even though the P-B’s publisher was in on some of the meetings.  Evidently, a contract of confidentiality had to be signed just to be in the meeting.

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The Mayo even agreed on a logo for the DMC after putting the design out to competitive bid in April, 2010-more than two years before the DMC project became public knowledge.

The Mayo has only hinted, for example, that a new $100 m tower at St. Mary’s hospital is probably first to be built as it can dovetail from a current construction project.  What kind of care will be available in this tower, we don’t know.  The Mayo receives more than $100 million in competitive peer review grants into cancer research alone, but the public amenities seem more open to discussion than any cutting edge technology.

By contrast, the Cleveland Clinic’s medical campus extols the innovation alley that’s being created to foster new technology that will bring better care to new patients.

The Mayo says 30,000-40,000 people will be hired over the next 20 years to create a world-class medical campus to compete with the Cleveland Clinics and the Johns Hopkinses of the world.  There’s no talk of whether any of those new workers will be doctors and nurses or valets and food servers.  It appears that patient satisfaction surveys have become more important than the patient outcomes and that marketing has become more marketing than medicine.

The Mayo could be a Destination Medical Center by ensuring that enough nurses and staff are hired to safely care for serious patients and promote better outcomes.  The Mayo could be a destination for innovative care by seeking out the toughest cases the medical world sees and solving those cases, regardless of the patient’s ability to pay.

There are other questions too.  Such as, will these “new” buildings include current union employees? And will agreements be in place to assure labor peace before construction begins?

But the biggest question remains, will patients make Rochester a destination without knowing what level of care they’ll receive?