10.24.2007
Massachusetts Patients Say Nurse Understaffing Compromises Patient Safety
Statewide
Survey Finds More Than 235,000 (>1-in-4) Patients Per Year Feel
Their Safety Has Been Compromised in Bay State Hospitals.
Hospital
Industry’s “Patients First” Website No Help
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Executive Summary
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Boston, MA – More than one-quarter of Massachusetts’
hospital patients and their families (28%) say that their safety,
or a family member’s safety, was compromised by nurse understaffing,
according to a statewide survey conducted by Opinion Dynamics
Corporation (ODC) of Cambridge, Massachusetts. Based on the total
number of hospital stays in the Commonwealth as tabulated by the
state’s Department of Health Care, Finance and Policy, this translates
into more than 235,000 Massachusetts patients annually who feel
that their safety is compromised by a lack of available nurses.
The new data is being presented today at a State House hearing
on pending legislation to establish safe nurse staffing levels
in Massachusetts’ hospitals.
In addition, more than one-third of these past patients and their
families (35%) say that their nurse had too many patients to care
for at once during their hospital stays. Half of all respondents
(49%) report they feel that a higher quality of care could have
been achieved while they were in the hospital if their nurses
had fewer patients to care for at one time. Almost three-quarters
of these patients (73%) say that the overall quality of patient
care in Massachusetts hospitals is suffering due to nurse understaffing.
“Massachusetts
patients are saying loudly and clearly that they are concerned
about the impact that the persistent understaffing of nurses in
Massachusetts hospitals is having on the safety of their care
during their hospital stays,“ said John McCormack, co-chair
of The Coalition to Protect Massachusetts Patients, an alliance
of 125 of the state’s leading health-care and consumer organizations
(see list, attached). “An alarming number of hospital patients
feel that patient care in hospitals is compromised by their nurses’
workloads, and that is making them fear for their safety.”
Survey respondents also provided new information indicating that
the hospital industry’s program of posting nurse-staffing averages
on the industry’s “Patients First” web site has little
or no value for prospective patients. Nearly 9 in 10 patients
report that they did not have the time to use the site to research
staffing levels prior to their hospital visits. Only 14% were
aware of the web site, and only 4% used it.
“Every
day in hospitals across the Commonwealth, patients are suffering
because of nurse understaffing,” said Karen Higgins R.N., the
other co-chair of the Coalition. “Every patient is at risk of
getting dangerously sick in the hospital or dying. One reason
that this is an issue is that nurses are regularly forced to care
for 6, 8 or 10 patients when they cannot possibly be in ten places
at once. A hospital-sponsored website, especially one that patients
say they don’t use, is not going to fix that condition.”
The belief that the safety of care was compromised appears to
stem from the fact that important elements of care are not being
delivered expeditiously.
- More than
one-third of past patients and their immediate family members
(43%) report nurses did not always arrive promptly when they
pushed their call buttons for assistance.
- More than
a third (38%) also report that medicine or other treatments
were not always provided in a timely fashion.
- One in
five patients (21%) report that nurses did not always arrive
promptly if complications arose.
Delays in care and nurse responsiveness have deadly consequences
for hospital patients, according to numerous studies. Press Gany
Associates, the nation’s leading patient satisfaction research
organization, issued a report in August that links a delay in
nurses’ responses to call buttons to an increase in hospital-acquired
infections and patient deaths. HealthGrades, another leading health-care
quality research firm, reported last year that as many as 80,000
elderly patients die each year in hospitals from preventable medical
errors, citing “failure to rescue,” which is a medical-research
term that refers to a nurse’s failure to promptly assess and treat
patient conditions that develop in the hospital.
Rise
in Hospital Infections Alarms Patients
The survey results come at a time when state and national health
care agencies are raising a red flag about the increasing dangers
associated with a hospital stay, specifically a rise in the incidence
of hospital-acquired infections that the CDC estimates kills more
people every year than AIDS.
The CDC further estimates that 2,000 patients, or 6 per day, are
dying in the Commonwealth annually because of hospital-acquired
infections and medical errors.
Survey respondents are equally worried. An astonishing 91% of
past patients surveyed say they are concerned about the more than
2 million people nationally who become ill from infections while
they are in the hospital, and about the fact that, of this number,
more than 90,000 patients die.
As noted above, a number of studies link the rise in these infections
and other medical complications to understaffing of nurses, including
one published in the July issue of the journal Medical Care that
found that safer RN staffing levels could reduce the incidence
of hospital-acquired infections by a remarkable 68%.
The statewide survey will be discussed at a State House hearing
on the House Bill 2059, The Patient Safety Act, which its advocates
believe is the key solution to the safety crisis in hospitals.
The legislation, calls on the state’s Department of Public Health
(DPH) to set a safe limit on the number of patients a nurse is
assigned to care for at once, requires that staffing levels be
adjusted based on patient needs, bans the dangerous practice of
mandatory overtime, and includes initiatives to increase nurse-faculty
and nurse recruitment. Members of The Coalition to Protect Massachusetts
Patients from throughout the Commonwealth will converge on Beacon
Hill to urge lawmakers to pass the legislation.
The survey found overwhelming support for the Patient Safety Act
by recent hospital patients, with 8-in-10 patients supporting
legislation to set safe limits on nurses’ patient assignments.
The ODC survey of 200 healthcare consumers who were hospitalized,
or who had family members hospitalized in the last two years was
conducted during the first week of October 2007. It was commissioned
by the Massachusetts Nurses Association, one of the leaders of
The Coalition to Protect Massachusetts Patients.
The Patient Safety Act is co-sponsored by State Senator Marc Pacheco
(D-Taunton) and State Representative Christine Canavan (D-Brockton).
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