“A very interesting article found on NJBIZ site.”
A poll by the state’s largest nurses union found 73 percent of voters support a law setting a maximum number of patients each nurse could be required to care for. The union, which is advocating for legislation to increase nurse staffing levels at hospitals and in other health care settings, commissioned the poll and released its results Thursday.
Mandating higher nurse staffing levels would significantly raise health care costs, according to the opponents of the bill, S1183, which is sponsored by state Sen. Joseph Vitale (D-Woodbridge), chair of the Senate health committee. The legislation would set nurse-to-patient standards for each hospital unit, with nurse input, allowing flexibility to increase staffing based on patient needs.
“Nurses know unsafe staffing levels will put quality health care at risk, and it turns out patients know that, too,” said Ann Twomey, president of the Health Professionals and Allied Employees union, which commissioned the survey conducted by Anzalone Liszt Grove Research.
“That’s why we are fighting for a safe staffing law, so every patient gets the care they need, when they need it,” she said “The best formula for patient safety is pretty simple — listen to your nurses,” Twomey said.
The bill is opposed by the New Jersey Hospital Association, which estimates it would require the state’s acute care hospitals to hire 2,054 additional registered nurses, at an annual cost of $159 million.
Aline Holmes, senior vice president, clinical affairs for the New Jersey Hospital Association, said staffing on a hospital floor is “based on the acuity of the patients and the experience and educational preparation of the nurses — it’s not a one-size-fits-all.”
She said mandating specific nurse/patient ratios, as the bill proposed, “does not guarantee quality or good patient outcomes.”
Holmes added, “What makes a difference is that the nursing staff knows their patients, they assess them at the beginning of the shift, (and) during their shift they make decisions about staffing.”
The poll asked two questions about the impact mandatory nurse staffing levels would have on health care costs.
Asked their reaction to the statement, “Setting a maximum number of patients per nurse would make the cost of health care go up so much, it would not be worth it,” 69 percent disagreed with the statement, 22 agreed with it and 9 percent said they didn’t know.
In response to the statement, “Hospitals could afford to add more nurses to their staff without major cost increases,” 59 percent said they agreed with the statement, 31 percent said they disagreed and 9 percent said they didn’t know.
The bill would require one registered professional nurse for every six patients on a medical/surgical unit for the first year after the regulations are adopted, and one nurse for every five patients thereafter. And it would set specific nurse/patient ratios in a number of clinical areas, such a trauma units, surgery and maternity.
The poll also found that 81 percent of voters support requiring the state Department of Health to conduct annual inspections of New Jersey hospitals. The DOH currently inspects hospitals in response to complaints, and hospitals are inspected periodically by independent hospital accrediting agencies, including the Joint Commission, which are authorized to inspect hospitals by the federal government.
DOH spokeswoman Dawn Thomas said New Jersey is one of 48 states that recognize CMS-approved accrediting agencies such as the Joint Commission “in lieu of routine state inspections of hospitals, which allows the department to use our resources on incident or complaint investigations.”
She said that, within two years, every general hospital undergoes an onsite inspection by the Department of Health.
Thomas said there are four accrediting agencies: The Joint Commission; DNV Healthcare; American Osteopathic Association/Healthcare Facilities Accreditation Program, or AOA/HFAP; and the Center for Improvement in Health Care Quality, or CIHQ.
The HPAE poll found 77 percent of voters “strongly agree” that setting nurse staffing levels in hospitals would improve the quality of health care in New Jersey.
Other findings in the poll include:
- 69 percent of voters say they trust nurses a lot when it comes to setting health care policy in New Jersey; more than they trust CEOs (6 percent) or Gov. Chris Christie (13 percent).
- 65 percent agree that, “If I found out a hospital had fewer nurses per patient than other hospitals — I would be less likely to use that hospital.”
- Voters support for increased nurse staffing and regular DOH hospital inspections crosses partisan lines, with majorities of Democrats, Republicans and unaffiliated voters supporting both proposals.
- Voters said they were more likely to vote for a legislator who supported these nurse-backed proposals (61 percent more likely versus 19 percent less likely).
According to HPAE, the state DOH in 2011 changed its regulations and moved to inspecting hospitals in response to complaints. Hospitals are inspected by accrediting agencies, but that is not sufficient, HPAE contends.
Twomey said “There is a real value in state inspections. When they were done in the past, they truly looked to make sure that (state) policies were actually being implemented, and we have lost that.”
“This survey shows nurses are the most reliable, trusted voice in health care, so it makes sense for hospital CEOs, legislators and the Governor to listen to what they have to say about providing quality patient care through safe staffing legislation,” she added.
But Holmes said staffing is based on acuity, or the level of patient medical needs. She noted that about a third of New Jersey hospitals have been designated as Magnet hospitals for nursing, a national accreditation that requires hospitals to meet a set of nursing criteria.
She also noted that all hospitals are striving to get more baccalaureate-prepared nurses because research has shown the presence of such highly educated nurses really does make a difference.
“We have dramatically improved quality and patient safety in our hospitals over the last 10 or 11 years without (nurse) staffing ratios by really putting in systems and educating staff about how to improve their environment so they can provide the best care possible,” she said.
The poll was conducted by telephone with 400 registered voters, between Feb. 9-12.