News from the Michigan Nurses Association
Contact: Dawn Kettinger, 517-721-9688
House committee hears how RN staffing affects hospital safety
As the issue of patient safety in hospitals grows more prominent in the public eye, a state House committee heard an update today from an international expert on nurse staffing and patient safety.
Sean Clarke, RN, PhD, FAAN, presented the bipartisan committee with a research perspective on why adequate registered nurse staffing is widely recognized as one of the most effective ways to keep patients safe in hospitals.
“Results are clear and compelling regarding increased risks of injury and death for patients at lower RN staffing levels,” Clarke told the Regulatory Reform Committee. Clarke is a professor and associate dean at Connell School of Nursing in Boston College in Chestnut Hill, MA. He has 15 years of experience in research on the issue, including work with the leading center in the field. “The overwhelming evidence from the research is that RN-to-patient ratios are among the most consistent predictors of the safety and quality of hospital care – and one of the few we can control.”
Nearly half of Michigan’s participating hospitals earned a “C” grade on patient safety, according to a report this week from the Leapfrog Group. The organization reports that its Hospital Safety Scores provide the most complete picture of avoidable hospital errors, accidents and infections that kill or harm tens of thousands of patients every year. Compared to A hospitals, patients in a C hospital have a 35% higher risk of dying of preventable harm.
The Michigan Health and Hospital Association, through voluntary reporting efforts, reported 52,000 incidents, near misses and unsafe conditions in Michigan hospitals in 2014, according to the 2015 Michigan Health and Hospital Association Patient Safety and Quality Annual Report.
Shelby Kivela, an RN who works in an Upper Peninsula hospital, said she left to work in another state in part because repeated mandatory overtime was taking a heavy toll on her and her patients.
“I was regularly working 16-hour days, sometimes back to back, because the hospital was understaffed,” Kivela said. “It’s very dangerous for nurses to work that exhausted, because one mistake can mean the difference between life and death for patients. I’m an advocate for my patients and I want to provide the best care possible at all times.”
Kivela shared how she left Michigan to work in a Boston hospital. Massachusetts’ law limits ICU nurses to taking one patient at a time, or two if that is safe.
“The law in Massachusetts protected me so I could pay attention to unstable patients who might need me for two hours at a time,” said Kivela, who now works in Michigan again and is the daughter of Rep. John Kivela (D-Marquette). “Situations that happen in Michigan would not have happened in Boston. I would like to see Michigan enact a law that protects my patients like that.”
Michigan’s Registered Nurses are frequently forced to care for too many patients at once, and patients are being harmed as a result, according to an independent survey that is the first of its kind ever done in Michigan.
Nearly 9-in-10 (86%) of RNs said patient care is suffering because they are assigned too many patients. Half (50%) of the Registered Nurses surveyed said they have an unsafe number of patients on at least half their shifts.
The independent study, commissioned by the Michigan Nurses Association and conducted by Anderson Robinson Research, also found that nurses reported awareness of various negative outcomes caused by RNs being assigned too
many patients, including preventable patient deaths.
Citing more than 200 scientific studies on RN staffing and patient safety, Clarke shared the following conclusions:
Legislators who heard from Clarke expressed concerns over the fact that:
The Michigan Nurses Association is advocating for the Safe Patient Care Act (HB 5013 and SB 574), which would establish minimum nurse-to-patient ratios in all hospitals, ban the rampant use of overtime and requires accountability and transparency on staffing from hospitals. The legislation has bipartisan support in both chambers, with 42 legislators signing on.
While the committee meeting was not a hearing on legislation per se, it reflects the growing interest in RN staffing and hospital safety among legislators on both sides of the aisle.
“We would like to thank Chairman Franz for making sure this important issue was heard in committee,” said John Armelagos, RN and President of the Michigan Nurses Association. “RN staffing levels at hospitals are a critical factor in patient safety, and there is growing bipartisan support for a legislative solution. We have come this far because nurses are speaking out, and we fully expect the conversation around the Safe Patient Care Act to continue.”