WSNA members & staff, with Rep. Dawn Morrell, looking on as the governor signs the bill.
The Safe Nurse Staffing Legislation (House Bill 3123) passed the Legislature with
near unanimous votes, and Governor Gregoire has signed the bill into
law. Highlights of the new law include:
- Each hospital, by September 2008, must establish a nurse staffing committee composed
at least half direct care nurses. This committee will develop, oversee and
evaluate a nurse staffing plan for each unit and shift of the hospital based on
patient care needs, appropriate skill mix of registered nurses and other nursing
personnel, layout of the unit, and national standards/recommendations on nurse staffing.
- If the staffing plan developed by the staffing committee is not adopted by the hospital,
the CEO must provide a written explanation of the reasons why to the committee.
- The staffing information must be posted in a public area and must include the nurse
staffing plan and the nurse staffing schedule, as well as the clinical staffing
relevant to that unit. It must be updated at least once every shift and made
available to patients and visitors upon request.
Ensuring safe nurse staffing has been a top priority for WSNA for the past several
years. A growing body of research confirms what we all know, that the care
provided by registered nurses has a direct impact on quality of hospital care and
patient safety. Nursing care requires continuous patient assessment, critical
thinking and expert judgment, advocating on behalf of our patients, and educating
patients and their families. Those activities are the essence of nursing care
and are critical factors in avoiding preventable complications, injuries and avoidable
deaths.
Here are the Facts:
- In a major study, risk of patient mortality within 30 days of admission among surgical
patients was found to increase by an average of 7% for every additional patient
in a nurses’ patient assignments
- Inadequate staffing was found to be a contributing factor in 24% of all unanticipated
events that resulted in patient death, injury, or permanent loss of function
- A higher proportion of hours of registered nursing care per day are associated with
better outcomes for hospitalized and these outcomes can result in significant cost-savings
to the system.
Over the past year, WSNA has collected and synthesized the evidence-based data
on nurse staffing, conducted nine regional workshops across the state on the history
and development of the nurse staffing outcomes data, our proposed legislation
and the legislation and regulation being considered and passed in other states.
WSNA has been working very hard throughout the past year to educate our members,
our legislators and our former opponents about the important evidence-based impact
of nurse staffing on patient safety and nurse retention and satisfaction. Since
last fall, WSNA has been engaged in a mediated process with the Washington State
Hospital Association, the Northwest Organization of Nurse Executives and the other
nurse unions on the critical issue of nurse staffing.
WSNA members & staff with Rep. Dawn Morrell before the bill signing.
In addition to the jointly supported legislation that passed in 2008, the collaboration
with the stakeholders also includes a Memorandum of Agreement that includes the
following ongoing work and discussions on nurse staffing:
- Establishment of a Ruckelshaus Steering Committee composed of two representatives
each of WSHA, NWONE, WSNA, SEIU, and UFCW.
- Dialogue through October of 2008 on minimum nurse staffing standards and public
disclosure of nursing sensitive quality indicators.
- Conduct a survey of all hospitals to compile the nursing sensitive quality indicators
currently collected by hospitals. Based on the results, selected those most
meaningful for hospitals to share with the staffing committee of the hospital and
the Ruckleshaus Steering Committee.
- Develop a process to identify, standardize, and collect at least five nurse sensitive
quality indicators to be collected by all Washington hospitals.
- Pilot project of an immediate staffing alert system designed to address real time
staffing concerns in several Washington hospitals.
- Establishment of an advisory committee to support the work of the staffing committees
in hospitals. The committee would compile nurse staffing guidelines; collect,
develop, and disseminate materials; serve as a resource and collect best practices;
and recommend and provide training for nurse staffing committees.
- Jointly urge the Washington State Department of Health to include nurse staffing
information on the state’s adverse events reporting form in order to examine the
impact of nurse staffing on the adverse event.
