The Patient Safety Act:  What the Bill Does

It protects patients safety

• The Act calls for the Massachusetts Department of Public Health (DPH) to develop and implement limits on the number of hospital patients assigned to Registered Nurses in Massachusetts. The limits would be based on scientific research and testimony from public hearings. Once established, the staffing levels would be adjusted in accordance with patient needs and requirements using a standardized, DPH-approved acuity system. An acuity system provides a means of measuring the illness level of the patients on a particular unit and their needs for care. 
   
• The Act would reduce errors caused by fatigue and overwork by prohibiting mandatory overtime, such as forcing RNs to work extra hours or double shifts.
   
• The Act stops hospitals from assigning unlicensed workers to perform care that demands licensed nursing expertise. Only nurses should provide nursing care.
   
• The Act protects against the reduction of other members of the health-care team including LPNs, aides, and technicians and instructs DPH to account for ancillary staff in the development of the staffing limits and the standardized acuity system.
   
• Provides patients the right to know and demand safe limits. The bill provides strong consumer protections, including prominent posting of the daily RN-to-patient limit on each unit, as well as a toll free hotline number, which may be used to report inadequate nurse staffing to DPH. Violations would be investigated by DPH with the potential for fines.

It is fair to hospitals

• The Act provides substantial lead times to phase in the new standards: teaching hospitals in two years, community hospitals in four years.
   
• It allows time-limited financial hardship waivers for eligible hospitals.
   
• The measure provides hospitals with flexibility: the limits would vary by the type of unit (intensive care unit, medical/surgical floor, emergency department, etc.) and patient assignments would also change based on variations in the severity of patients’ illnesses and other factors.

It will bring more nurses to the bedside

• The Act creates programs to increase nursing faculty in nursing schools and offers nurse recruitment initiatives, including nursing scholarships and mentorship programs.
   
• Thousands of RNs say they will return to the bedside if there are safe staffing limits, and the bill provides for refresher programs to help them return to bedside nursing.