Daily Archives: April 29, 2015

04.29.15
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Safe Staffing Act

The American Nurses Association (ANA) commends Senator Jeff Merkley (D-OR) and Representatives Lois Capps (D-CA) and David Joyce (R-OH) for introducing the Registered Nurse Safe Staffing Act. This bill would require Medicare-participating hospitals to establish registered nurse (RN) staffing plans using a committee, comprised of a majority of direct care nurses, to ensure patient safety, reduce re-admissions and improve nurse retention.

Endorsed by ANA, the Registered Nurse Safe Staffing Act (H.R. 2083/ S. 1132) presents a balanced approach to ensure adequate RN staffing by recognizing that direct care nurses, working closely with managers, are best equipped to determine the staffing level for their patients. Without the necessary nurse coverage, patients risk longer hospital stays, increased infections, avoidable medication errors, falls, injuries and even death.

The bill’s sponsors chair Congress’ Nursing Caucus, Merkley in the Senate and Capps and Joyce jointly in the House. The Nursing Caucus educates lawmakers on issues significant to the profession and patients, and the impact of nurses on the health care system.

“Optimal nurse staffing could mean the difference between a patient surviving or dying,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. “Research tells us it’s that crucial. If you or your loved one were in the hospital, you’d want to be certain that the hospital was continually setting, evaluating and adjusting its nursing coverage to meet your changing needs and the conditions of all patients. That is what this legislation seeks to ensure.”

Research has shown that higher staffing levels by experienced RNs are linked to lower rates of patient falls, infections, medication errors and even death. One study showed the likelihood of overall patient mortality (in-hospital death) and mortality following a complication increases by 7 percent for each additional patient added to the average RN workload.

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.

In setting staffing plans, the Registered Nurse Safe Staffing Act considers:

  • RN educational preparation, professional certification and level of clinical experience.
  • The number and capacity of available health care personnel, geography of a unit and available technology.
  • Intensity, complexity and stability of patients.

 

It also includes these patient protection, reporting, investigation and enforcement provisions:

  • RNs would not be forced to work in units where they are not trained or experienced without orientation.
  • Procedures for receiving and investigating complaints.
  • Potential for civil monetary penalties imposed by the Secretary of Health and Human Services for each known violation.
  • Whistleblower protections.
  • Public reporting of staffing information.

 

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ANA is the only full-service professional organization representing the interests of the nation’s 3.1 million registered nurses through its constituent and state nurses associations and its organizational affiliates. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.

04.29.15
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Florida Legislature Goes Home Early Over Medicaid Impasse

The Florida Legislature – at odds over the expansion of Medicaid – abruptly ended its session three days early on Tuesday, leaving hundreds of bills unrelated to health care unfinished.

Shortly after the adjournment, Gov. Rick Scott, a Republican, filed a lawsuit against the federal government over the same issue.

Here’s a brief overview of the fight: The Republican-led state House is firmly against Medicaid expansion, while the Republican-led state Senate supports it. Scott once supported expansion but is now against it.

And the federal government raised the stakes of the battle by refusing to negotiate on the renewal of $2 billion in funds, mainly for the Low Income Pool program, which reimburses hospitals for unpaid bills. The federal funding will expire at the end of June.

“The pool money was about helping low-income people have access,” Health and Human Services Secretary Sylvia Burwell told WFSU in January. “I think we believe an important way to extend that coverage to low-income individuals is what passed in the Affordable Care Act, is this issue of Medicaid expansion.”

Scott’s suit says it’s a case of coercion – Florida must expand Medicaid or lose $2 billion – and that was expressly forbidden by the Supreme Court when it upheld the health law in 2012.

Close to 800,000 Floridians could gain coverage if the state expands Medicaid.

House Appropriations Chief Richard Corcoran recently delivered a 20-minute speech against Medicaid to fellow lawmakers.

“Here’s my message to the Senate: They want us to come dance? We’re not dancing,” Corcoran said. “We’re not dancing this session, we’re not dancing next session, we’re not dancing next summer. We’re not dancing. And if you want to blow up the process because you think you have some right that doesn’t exist? Have at it.”

Senate President Andy Gardiner says he’s disappointed with the House’s decision: “The House didn’t win, the Senate didn’t win and the taxpayers lost. There are a lot of issues that aren’t going to make it, and it’s unfortunate.”

But House Speaker Steve Crisafulli says it was the right thing to do: “We’ve made every effort we can to negotiate with the Senate on a budget and at this time they’re standing strong on Medicaid expansion.”

Crisafulli’s top legislative priority, water policy reform, is among the many bills left hanging this session.

Scott tried to pressure the Legislature to the bargaining table to craft a state budget. He threatened to veto Senate priorities, but the Senate remained unmoved.

Now, the one task the Legislature is mandated to do — pass a budget — remains incomplete. Scott has said he will call the Legislature back for a special session to complete the budget.

This story is part of a reporting partnership that includes WFSU, NPR and Kaiser Health News.  

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.