Patient Protection LAW!

pickledpepperRN · Nov 27, 2003

http://www.calnurse.org/cna/press/112503.html

Data Shows Growth of RN Workforce as California

Nears Implementation of Landmark Safe Staffing Law

The advent of California's landmark Safe Staffing Law is helping to increase the size of the registered nurse workforce - far beyond the number of new RNs needed to meet the requirements of the law, the California Nurses Association said today.

As of January 1, 2004, all hospitals must be staffed in accordance with the new law, sponsored by CNA, which requires minimum RN-to-patient ratios in all hospital units. While some hospitals are hiring RNs and working to comply with the law, some are continuing to seek delays or revisions claiming they are unable to find the needed RNs due to the nursing shortage.

But data compiled by the state Board of Registered Nursing, the agency that licenses RNs in California shows that overall California today has over 30,000 more actively licensed RNs than the BRN estimated the state would have at this date - six times the number the state health department estimated would be needed for the ratios.

The Department of Health Services has said that statewide a total of 4,880 RNs additional will be needed to meet the ratios in 2004 and another 2,350 in 2005, numbers well within reach for hospitals that are actively working to implement the law, says CNA.

In 1997, the last time the BRN conducted a statewide survey of RNs, the BRN projected a small annual increase of only 2,000 RNs per year (based restructuring era trends and the number of new grads, minus those leaving the workforce). But the numbers have been growing by about 10,000 per year, even after subtracting those leaving.

Specifically, the BRN projected that based on trends in evidence in the mid-1990s, the number of actively licensed RNs in California entering 2004 would be 253,939. As of September 30, 2003, California had 285,134 actively licensed RNs (BRN stats).

Much of the increase results from a dramatic influx of RNs into California from other states or countries, but the numbers also reflect the first signs of the rebuilding of the nursing education and training infrastructure in California.

Every year California's nursing schools graduate 5,100 new RNs. After years of cuts in nursing education, California has increased capacity in its nursing programs the past two years and can now admit 6,600 students per year (of the 10,000 annual applicants for nursing school).

California last year approved a new $60 million nurse workforce initiative. The first phase, $21 million, allocated through 13 regional partnerships, will add an additional 2,000 RNs. The next stage, $24 million over three years, will boost the RN rolls by another 2,400.

Further, Australia has provided an example of the salutary effect of ratios on expanding the RN workforce.

In Victoria, Australia, where ratios were implemented in 2001, hospitals are able to staff with the ratios - while other Australian states battle their own nursing shortage - and demand for nursing courses is up 26.5%.

Ratios should help repair the patient safety net

The ratio law should also go a long way to helping repair the patient safety net which has been tattered by years of the adverse effects of corporate-oriented business practices in the hospital industry and managed care. Studies by the nation's most respected scientific and medical researchers affirm the significance of the ratio law for patient safety.

The Institutes of Medicine of the National Academy of Sciences reports that "nurse staffing levels affect patient outcomes and safety." Insufficient monitoring of patients, caused by poor working conditions and the assignment of too few RNs, increases the likelihood of patient deaths and injuries at a time when avoidable medical errors kill up to 98,000 people in U.S. hospitals every year. (IOM, November 4, 2003)

Inadequate staffing precipitated one-fourth of all sentinel events - unexpected occurrences that led to patient deaths, injuries, or permanent loss of function - reported to JCAHO, the Joint Commission on Accreditation of Hospital Organizations, the past five years. (JCAHO, August 7, 2002)

A New England Journal of Medicine study documented that improved RN-to-patient ratios reduce rates of pneumonia, urinary infections, shock, cardiac arrest, gastrointestinal bleeding, and other adverse outcomes. (NEJM, May 30, 2002)

Research in the Journal of the American Medical Association found that up to 20,000 patient deaths each year can be linked to preventable patient deaths. For each additional patient assigned to an RN the likelihood of death within 30 days increased by 7 percent. Four additional patients increased the risk of death by 31%. (JAMA, October 22, 2002)

Nurses intercept 86% of all medication errors made by physicians, pharmacists, and others prior to the provision of those medications to patients. (JAMA, 1995)

More information is also available on the CNA website at http://www.calnurse.org http://www.calnurse.org>

Agnus · Nov 29, 2003

Just courious.

Since travelers must also be registered with the BON, how many of these new nurses registered with the state board are acutally travel nurses who will leave after 1-2 assignments?

I think with the influx of traveleres of late this could skew the figures in favor of the CNA.