[NRSKarenRN]

The Politics of Caring

American Journal of Nursing - August, 2004 - Volume 104, Issue 08



By Rose Gonzalez, MPS, RN, and Margaret Kay


Federal Update Recent publicity about an RN claiming responsibility for as many as 40 patient murders in various medical facilities has focused public, media, and legislative attention on the lack of a national information clearinghouse for RNs and other licensed health care professionals who have been disciplined for providing poor care or have been convicted of crimes related to such care.

In response to this need, Senators John Corzine (D-NJ) and Frank Lautenberg (D-NJ) have worked with the ANA to draft legislation establishing such a national reporting system, which will expand on the National Practitioner Data Bank (NPDB), created in 1986 to track licensing, disciplinary, and medical malpractice actions taken against U.S. physicians and dentists. While RNs have been included in the NPDB, reporting their actions has not been required.

In addition to protecting patients, the Safe Health Care Reporting (SHARE) Act of 2004 (S 2341) would provide due-process protections for RNs who have been reported, including the right to adequate notice and review of the report, the ability for the RN to request a hearing before an arbitrator to contest the report, the right to legal or union representation at any such hearing, the right to question witnesses, and the right to review the final written report of the arbitrator. The SHARE Act also would protect nurse whistleblowers from employment discrimination and retaliation.

The SHARE Act has been referred to the Senate Health, Education, Labor, and Pensions Committee. For further updates, check www.anapoliticalpower.org.



State News The New York State Assembly recently passed a bill that would require health care facilities to publicly disclose the number of RNs, licensed practical nurses, and unlicensed personnel providing patient care, as well as the hours of nursing care provided to each patient. The New York State Nurses Association applauds the passage of the measure because its enactment would give patients and their families vital information that would help them determine where they can receive the best available nursing care. Studies have shown that having too few RNs per unit leads to higher death rates and levels of patient complications. Furthermore, facilities would be required to report the incidence of these complications, such as medication errors, bedsores, and urinary tract infections. Finally, the bill would prevent health care workers from calling themselves nurses unless they are licensed RNs or LPNs, a much-needed protection for both the public and nurses.

Tips for Political Action

You can change the world with one vote, but you can’t vote if you’re not registered. Most jurisdictions have September or October cutoff dates for registering in time for the November 2nd general election. To find out the cutoff time for your area, go to www.anapoliticalpower.org and click on “Election 2004 Action Center” and then “Election Dates and Voter Registration Deadlines by State.” From that page you can learn more about how to register in your area by clicking on the link to “online voter registration tools,” which offers links to numerous helpful Web sites.


Rose Gonzalez is director of government affairs and Margaret Kay is periodicals manager at the ANA.
---------------------
American Journal of Nursing - July, 2004 - Volume 104, Issue 07


By Erin McKeon and Michelle Artz

Representative Maurice Hinchey (D-NY) introduced the Patient Safety Act (HR 4374) on May 17, 2004. The ANA is a strong supporter of this legislation, which would give patients crucial information to make informed health care decisions.
The ANA maintains that, as a major payer for health care services for individuals entitled to benefits under Medicare and Medicaid, the federal government has a compelling interest to ensure that these beneficiaries receive high-quality care. Decades of research have shown that nurse staffing levels are the primary indicator of safe and effective care.

Research by Aiken and colleagues in the October 23, 2002, issue of the Journal of the American Medical Association demonstrated that RN staffing levels have a significant impact on preventable deaths in hospitals, and that a patient’s likelihood of dying within 30 days of admission increases 7% for every additional patient added to the average RN’s workload. The Joint Com­mission on the Accreditation of Healthcare Organizations reported in Health Care at the Crossroads in 2002 that inadequate nurse staffing contributes to nearly a quarter of all unexpected incidents that kill or injure hospitalized patients. Recent research conducted by the Centers for Medicare and Medicaid Services (CMS) published in 2001 found strong, objective proof that nurse staffing in nursing homes is directly related to quality measures. When staffing levels dropped below a certain threshold, the incidence of sepsis, urinary tract infections, pressure ulcers, and weight loss increased. (See www.cms.hhs.gov/medicaid/reports/rp700hmp.asp to read the report.)

Given the strong relationship between nurse staffing and quality of care, the ANA believes that patients should have easy access to reliable information regarding nurse staffing. The Patient Safety Act would require health care facilities to regularly report auditable data on RN, LPN, and unlicensed personnel staffing to the CMS. This data would then be made publicly available by the CMS (also on its Web site). Hospitals would also be required to report risk-adjusted mortality rates and incidences of medication errors, pressure ulcers, and nosocomial infections, including nosocomial urinary tract infections. The bill also provides whistleblower protections to nurses who report conditions dangerous to patients or that violate conditions of participation in the Medicare program.

More information is available at the ANA government affairs Web site: www.anapoliticalpower.org.