Safe Patient Standard Bill Introduced in MN House

 

Bill would allow flexibility for hospitals, protection for nurses to keep patients safe

 

(St. Paul) - In response to greater evidence that patients do better with more nurses, Minnesota lawmakers have introduced the Safe Patient Standard bill in the Minnesota House of Representatives (HF 1654).  The SPS bill would set a minimum standard of staffing for nurses that would be flexible enough for each department and floor in each hospital in Minnesota, regardless of the size of the facility or the number of patients in the beds.

"As a patient, you're in the most vulnerable position of your life," said Linda Hamilton, RN, BSN, president of the Minnesota Nurses Association, "and when nurses are taking care of too many patients at one time, the quality of care suffers.  Then patients suffer.  They're in pain.  They can't get up.  They wonder where their nurse is."

A recent study issued by the Minnesota Department of Health found a strong correlation between nurse staffing and patient outcomes, including patient mortality, failures to rescue, and falls in the hospital.  MDH studied literature from a wide collection of sources to determine that patients are more likely to be harmed when nurse staffing decreases.

"Frontline nurses are worried about their patients," Hamilton said.  "They know patients are ringing their call lights.  They know patients are waiting or they're not being assessed properly.  We're not delivering the safe, quality care that Minnesotans expect and deserve."

Minnesota's overall healthcare quality score fell 11 percent in 2013, according to the Agency for Healthcare Research and Quality (AHRQ), and Minnesota now ranks 15th on watchdog group Leapfrog's Hospital Quality Safety Score.  Those studies take into account readmissions and incidents of infections, bedsores, and falls, which the MDH study lacked.

Minnesota nurses file forms with MNA and their managers when they perceive a staffing situation puts patients at risk.  Nurses filed more than 2000 Concern For Safe Staffing forms with MNA in calendar year 2014.  That figure surpasses 2011, 2012, and 2013.  CFSS forms are filed in addition to incident reports or adverse event reports that are filed with the state. 

The SPS bill would establish a state workgroup that would determine a minimum standard of staffing for each unit for various hospital sizes.  Where patient care is typically more acute, such as in an intensive care unit (ICU), staffing would be higher than in a unit with typically lower acuity, such as an orthopedic unit.  Hospitals would still be free to move nurses from unit to unit as they do now with "float pools" and be flexible in the event of an epidemic situation, which happened during the flu outbreak of 2013.

“We have a standard of excellence in healthcare in Minnesota,” said Rep. Joe Atkins (DFL-Inver Grove Heights), “and we’re not always meeting that.  The legislation that’s been brought forward sets a minimum standard for staffing that protects Minnesotans, wherever they’re being taken care of.  It’s a Minnesota solution that brings together hospitals, nurses, and the health department to ensure no one has to suffer in a hospital bed wondering where their nurse is.”

In the event nurses find themselves in an unsafe situation, the SPS bill protects nurses who report it to their managers, close units to new patients, or report the incident to the health department. 

"We all care for patients," Hamilton said, "and we need to work together to determine the safety standards that Minnesota hospitals need to follow to ensure that patients are safe and well cared for.  We owe them that much.  They're in our care.  We're in their trust."