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Moore testifies in support of his bill to promote the nursing profession and safe patient care
October 24, 2007...Today, Sen. Richard T. Moore, D-Uxbridge, delivered testimony before the Joint Committee on Public Health in support of legislation he filed that would provide a process to bolster the supply of nurses and nurse faculty through incentives for students and matching grants for hospitals. It also creates a public accountability process for developing staffing patterns for patient care. The bill further provides a process to evaluate and report on measures to improve the quality of patient care and ensure transparency in hospital nurse staffing.
The text of Sen. Moore's testimony:
Testimony of Senator Richard T. Moore before the Joint Committee
on Public Health in support of S. 1244, An Act to Promote the Nursing
Profession and Promote Safe Patient Care.
For some time now, there has been considerable debate and discussion of the issue of patient safety as it relates to the role of nursing in our health care facilities. Each side of the debate seek to address concerns relative to the safe care of patients, but offer solutions that are significantly different.
Both sides recognize a shortage of nurses that will continue to grow as the number of elderly residents needing care increases significantly faster than to most optimistic projection of the size of the state’s nursing workforce. Both sides agree that having more nurses to serve the increasingly complex patient case load is a desirable goal. The University of Massachusetts Medical School’s Division of Commonwealth Medicine analyzed both bills last year, and made recommendations. As the principal sponsor of Senate Bill No. 1260, I have redrafted my bill to address the issues raised by the UMASS research team.
My redrafted bill, S 1244 is significantly improved from the original bill. It provides for:
- An analysis of the health care workforce needs in Massachusetts and redesign of state initiatives to address the shortage of nurses.
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- Development of a statewide plan to promote health care professions to encourage more people to consider careers in health care, especially nursing.
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- The creation and collection of nursing workforce data related to the practice of nursing, the supply needs of the nursing workforce, the supply needs for nursing faculty and other information needed to improve the profession of nursing.
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- Establishment of the Clara Barton Nursing Excellence Program with $30 million to begin funding nursing student loan repayment assistance, a nursing scholarship program, a matching grant program with hospitals to promote more clinical settings, nursing faculty bonuses of $25,000/yr. for up to ten years to make teach more competitive with clinical nursing, and $5,000/yr. stipends for experienced nurses to mentor new nurses.
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- Provide accountability in nurse staffing plans by requiring hospitals to publicly post staffing plans addressing patient needs by identifying the appropriate number and mix of nursing staff for each hospital specific to each shift and unit, including a mechanism for accepting input from nurses and nurse managers. Hospitals will be subject to a $1,000 per day late penalty for failure to submit plans with the penalty fees deposited in the Clara Barton Nursing Excellence Trust Fund to be used to further enhance nursing. The Department of Public Health may require hospitals to revise plans as needed.
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- Requirement that hospitals participate in an evaluation of nurse staffing plans in relation to nursing sensitive patient outcomes using at least three nationally accepted measurements, including the National Data Bank of Nursing Quality Indicators measuring patient hours per patient day. The Betsy Lehman Center for Patient Safety in the Department of Public Health will be responsible for evaluating the effectiveness of the staffing plans in addressing patient needs.
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- Limits nursing work hours and mandatory overtime by prohibiting nurses from working more than 12 hours in any given shift, not to exceed 16 hours in a 24 hour period. Prohibits any disciplinary action for refusing to work beyond the specified hours. A nurse who works 12 consecutive hours in a shift must be given 10 hours off from any work between shifts. Nurses may not exceed work hours by working at other health care institutions. This provision is expected to significantly improve patient and nurse safety.
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- Requires all licensed nursing homes to have a registered nurse on duty at all times.
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- Establishes a commission to evaluate nursing hours in order to reduce fatigue and improve patient safety consistent with the recommendations of the Institute of Medicine’s report “Keeping Patients Safe: Transforming the Work Environment of Nurses.
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What S. 1244 does not include is any provision for specific nurse – to – patient staffing ratios. The reason for this is that while there is considerable research that supports the importance of adequate nursing, no evidence-based research has been able to clearly identify what specific ratios are appropriate. The reasons for this are that the condition of patients can change for better or worse within a shift; the physical ability, education, and experience of the nurses on duty varies among nurses; and the hospital setting, availability of support staff, and technology vary widely among hospitals.
Passage of S. 1244 would be a giant step forward in improving patient safety and the nursing profession. It will also help to address the growing shortage of nurses that threatens the viability of our entire health care system in the coming years. Let’s put the question of nurse staffing ratios aside and achieve a major victory for patients and nurses. Everyone, including the MNA because of their advocacy, can justifiably take credit for such an achievement!
Thank you.
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