57% of District Hospital RNs Cite Inadequate Staffing

New study shows hospitals with higher RN staffing had lower re-admissions

Registered nurses from District of Columbia hospitals applauded the movement forward of the DC Patient Protection Act, a bill they say is critical to their ability to provide safe patient care.

The Patient Protection Act, introduced in February by Council Chairman Phil Mendelson, has a Nov. 8 hearing date before the District Council Health Committee. All told, the bill has the support of 10 of the 13 council members and broad community support with endorsements from more than 40 organizations representing religious, labor, and community groups across the District.

“This is a great step forward in the fight to elevate patient care standards in hospitals throughout our nation’s capital,” said Rajini Raj, RN, a cardiac nurse at Washington Hospital Center. “RNs are being forced to care for too many patients at one time, and patients suffer the consequences.

“After years of failed attempts to get our hospitals to work directly with the nurses to address safe nurse-to-patient staffing, we need legislation to hold our hospital administrators accountable,” she said. “It is long past time for the District Council to vote on this vital piece of legislation.”

The law would require minimum, mandatory standards of nurse staffing in all district acute-care hospitals – a proven way to save patient lives, cut down on medical errors, decrease hospital-acquired infections, reduce pressure sores and the frequency of patient falls and injuries, and minimize hospital readmissions — to ensure safe staffing for patients at all times at all DC hospitals. 

New study: Safe staffing curbs hospital readmissions

The announcement of the hearing date comes on the heels of a new study released this week by researchers at the University of Pennsylvania School of Nursing who looked at nursing staffing levels and readmission data from 2,826 hospitals. It documented that hospitals with high nurse staff levels had 25 percent lower odds of being penalized compared to facilities with lower nurse-staffing ratios. Higher nurse-staffed hospitals also had 41 percent lower odds of receiving the maximum penalty for readmissions.

Several hospitals in the District of Columbia have been penalized by the Centers for Medicare and Medicaid Services for unnecessarily high readmission rates.

Introduction of the bill in February followed reports of a fall 2012 NNU survey of DC-area RNs which found 57 percent of DC nurses say staffing is inadequate always or almost always; 64 percent said they have less time to care for patients; and 87 percent say that mandatory nurse-to-patient ratios, such as those in California, are needed in DC.

The bill is modeled after a highly successful California law that, since its implementation nine years ago, has saved thousands of patient lives, promoted improved overall quality of care, and helped keep the state’s most experienced nurses at the bedside.

Other studies have proven the correlation between lower numbers of patients assigned per patient, resulting in improved patient outcomes. A prominent 2010 University of Pennsylvania study comparing California hospitals to New Jersey and Pennsylvania hospitals found that New Jersey hospitals would have 14 percent fewer patient deaths and Pennsylvania 11 percent fewer deaths if they matched California’s ratios in surgical units, and that fewer California RNs miss changes in patient conditions because of their workload, and nurses have more confidence that patients can manage on their own after discharge.

A September 2012 report by the Agency for Health Care Research and Quality of the U.S. Department of Health and Human Services, titled “State Mandated Nurse Staffing Levels Alleviate Workloads, Leading to Lower Patient Mortality and Higher Nurse Satisfaction,” emphasized the correlation between higher nurse workloads that are associated with more patient deaths, complications, and medical errors.

National Nurses United is the largest and fastest-growing professional organization for direct-care RNs, representing 186,000 nurses in every state. NNU, together with its affiliate, the DC Nurses Association, represents 4,000 RNs in the District of Columbia employed at six hospitals, including the DC Department of Health.

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