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10 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G A P R I L | M AY | J U N E 2 0 1 9 NATIONAL N ational nurses united in May welcomed the reintroduction of the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (H.R. 2581), sponsored by Sen. Sher- rod Brown in the Senate and Rep. Jan Schakowsky in the House. This key legislation addresses an epidemic of deliberate under- staffing in our nation's hospitals that puts patients and the public at risk, said NNU. "Registered nurses are on the frontlines of caring for our patients, and yet we are often unable to deliver the care that patients need because hospital administrators dangerously understaff our facilities to increase profits," said Bonnie Castillo, RN, executive director of NNU. "We know from numerous scientific studies, and from the results of the landmark nurse-to-patient ratios law in California, that mandatory, minimum nurse-to-patient ratios save patients' lives and improve quality of care. NNU commends Senator Brown and Congresswoman Schakowsky on their lead- ership on this issue." Nurses know there is a patient safety crisis in hospitals and medical facilities across the United States. According to the most conser- vative estimates, approximately 250,000 American patients die annually from preventable errors. That translates into near- ly 685 patients a day. Studies show that when RNs are forced to care for too many patients at a time, the risk of preventable medical errors and avoidable complications increases. "Nurses work long hours doing vital work in our health care system—their jobs are crit- ical to keeping patients safe and providing the highest quality care," said Sen. Brown. "But too often, nurses are stretched too thin, caring for too many patients with not enough support. We can prevent that by ensuring nurses are adequately staffed, and protecting their ability to go to hospital management without fearing potential retaliation." "Safe staffing levels save lives" said Rep. Schakowsky. "This bill will improve the health of patients by improving nursing care—establishing minimum registered nurse-to-patient ratios in hospitals, protect- ing the rights of nurses to advocate on behalf of their patients, and investing in training and retaining nurses. It is past time that we act on the evidence and give nurses the support they deserve, and put patients over profits." Nurse-to-Patient Ratios California is the only state in the nation with mandated nurse-to- patient ratios across all units and for all shifts. The research from California provides irrefutable proof that adequate minimum nurse-to-patient ratios saves lives. In 2010, a landmark study published in Health Services Research, found that New Jersey hospitals would have nearly 14 percent fewer patient deaths and Pennsylvania would have nearly 11 percent fewer deaths if they matched California's ratios in medical-surgical units. Studies show that when RNs are forced to care for too many patients at one time, patients are at higher risk of preventable medical errors, falls and injuries, certain medical complications, increased length of hospital stays, and readmissions. In addition, a 2007 meta-study found that adding one more full-time RN to a patient day was linked to a 9 percent decrease of deaths in ICU patients, a 16 percent decrease in deaths in surgical patients, and a 6 percent decrease in death in medical patients. Nurse Staffing Standards for H.R. 2581 The Hospital Patient Safety and Quality Care Act mandates unit-specific RN-to-patient ratios for acute-care hospitals and requires that RN-to-patient ratios must be followed on all shifts, without averaging. The bill incorporates an acuity system to allow for bedside nurses to utilize their professional judgement to decide the acuity and level of care of patients. It also prohibits the substitution of direct patient care and RN professional judgement with video monitors or technology. H.R. 2581 provides strong whistle blower protections for nurses who speak out against assignments that are unsafe for patients or nurses. The act also includes monetary fines for violations. Sen. Brown's bill is cosponsored by Sens. Tammy Baldwin (Wisconsin), Kamala Harris (California), Bernie Sanders (Vermont), and Elizabeth Warren (Massa- chusetts).—Staff report NNU reintroduces federal safe staffing ratios bill NEWS BRIEFS