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Massachusetts Second State to Consider Nurse Staffing Ratios; Experts to Appear at Public Hearing

July 12, 2005

Boston, Mass. (July 12) ““ At a time when the nursing shortage is entering its eighth year and health care costs continue to skyrocket, preventing medical errors is at the forefront of two competing bills before the Massachusetts legislature. This week, the legislature is holding a hearing on the charged issue of whether the state should mandate minimum nurse-to-patient ratios in hospitals. Today, the Massachusetts Health Policy Forum (MHPF), and the New England Public Policy Center released a report detailing the benefits, costs and consequences of this option.

National research demonstrates that an increase in the number of nurses is associated with fewer deaths, shorter hospital stays, and lower rates of complications such as pneumonia, shock, and cardiac arrest. Despite this fact, there is no consensus among health-care experts that mandating the number of registered nurses is the best course of action. The Massachusetts legislature is only the second in the nation to seriously consider mandatory minimum nurse staffing ratios. California enacted such requirements in January 2004, but it is still too early to evaluate whether this law has resulted in improved patient safety.

The Forum, in collaboration with the New England Public Policy Center, recently gathered national health policy experts, health-care leaders and legislators to inform the Commonwealth’s debate about this complex issue. Phil Johnston, chair of the Massachusetts Health Policy Forum, urged leaders to find common ground: “Massachusetts hospitals lead the world in research and sheer talent, but the health care community must work together now to create an effective plan to ensure patients are safe and we are preventing medical errors.”

Michael Doonan, a social policy researcher at Brandeis University’s Heller School and Executive Director of MHPF, will share the latest findings on nurse staffing research before the Committee on Public Health on Wednesday, July 13, Massachusetts State House, Room A1. The hearing begins at 10 a.m.

The findings include:

- The number and skill of staff nurses play a critical role in patient outcomes across a range of conditions in the hospital setting; however, research has not yet shown, and may be unable to show, the optimal nurse-to-patient ratio.

- Patient outcomes depend not only on the kind and severity of patients’ illnesses, but also on human resources factors such as the mix of nurses, doctors, and auxiliary personnel, and on the work environment or culture of the hospital.

- The current nursing shortage complicates the feasibility of increasing nurse-to-patient ratios. Massachusetts leads the nation with the most registered nurses per capita. However, the Health Resources and Services Administration forecasts the state’s unmet demand for nurses will rise from five-thousand today to 25-thousand by 2020.

- Rep. Christine Canavan (D-Brockton) sponsored the legislation to require minimum nurse-to-patient ratios in hospitals. These requirements are stronger than those enacted in California and would be the most stringent in the nation. Cost estimates on implementing Rep. Canavan’s proposal range from $250 million to $450 million. Alternative legislation sponsored by Senator Richard Moore (D-Uxbridge), Chairman of the Joint Committee on Health Care Financing, seeks to increase the supply of nurses and to better track and share information on patient outcomes and nurse workloads.

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