Testimony on
HB No. 4272
House Committee On Health Policy
April 1, 2003
Submitted by Victoria J. Boyce, RN, MSN
Good morning. My name is Victoria Boyce. I am a registered nurse
in the Emergency Department at St. John Hospital & Medical Center
in Detroit and a member of the Michigan Nurses Association where
I am currently serving as the Director of Government Affairs.
MNA is here in support of House Bill 4272 introduced by Representatives
Ehardt, Huizenga, Vander Veen and Voorhees to establish the Governor's
Commission on Patient Safety. The sponsors are to be applauded for
recognizing that the most effective solutions for reducing errors
in health care reside with those who fight in the system and with
the processes every day. In proposing a multidisciplinary panel
of health care providers for the commission, you have modeled the
composition that every facility should replicate as they examine
error reduction, patient safety, and quality of care in their own
setting.
We are pleased that the Michigan Nurses Association has been named
as one of the organizations from which input would be sought regarding
patient safety.
Registered nurses are the largest group of health care professionals
and provide the most direct and continuous care in virtually every
health care setting. As advocates for our patients, we continually
address patient safety and quality concerns as we go about our work
of caring for people.
It is no secret that the nation is just beginning to see the effects
of an impending shortage of nurses that is projected to number over
800,000 by the year 2020. In order to address future problems in
the nursing workforce and the health care system, steps need to
be taken now. Recently a number of studies have pointed out the
direct relationship between quality patient care, effective nursing
care, and retention of nurses in the workforce.
For instance, in a survey by the United American Nurses, 85 percent
of registered staff nurses responding believed that a reduced nurse/patient
ratio would improve the nursing shortage. In another study, researchers
at the University of Pennsylvania found that each additional patient
in a nurse's workload translated to about a 7 percent increase in
the likelihood that the patient would die within thirty days of
admission and a 23 per cent higher burn out rate for nurses.
MNA is currently working with the members of the Michigan Health
and Safety Coalition on a variety of initiatives relating to patient
safety, and is a leader in the Nurse Staffing Quality Initiative
to look at the relationship between nurse staffing and patient outcomes.
No doubt the governor's commission will heavily refer to this body
of work.
A series of studies have consistently shown the relationship between
better patient outcomes and nurse staffing. These outcomes include
lower incidence of pressure ulcers and infections, fewer medication
errors and falls, and decreased failure to rescue along with shorter
lengths of hospital stay. There are a number of other studies being
conducted including one to establish the relationship between medication
errors and nurses working overtime.
I'm no doubt preaching somewhat to the choir here this morning,
but I want to emphasize the direct links between nurses, patient
safety, and quality of care. MNA already works with a number of
organizations that will be included in this Commission. It is essential,
however, that the voice of nursing is heard clearly when discussing
patient safety. Nurses, especially in hospital settings, are one
of the few provider groups who deliver direct care on a 24 hour-a
day, 365 day a year basis. We are uniquely qualified to offer quantitative
information on the issue of patient safety and propose changes to
work environments and processes in order to decrease errors and
improve patient safety and quality of care.
The public has a right to expect health care that is safe and effective.
Our profession is responsible to individual patients, and to the
public, to continuously seek to improve the quality of nursing services
and health care, and to help ensure that health-related services
are provided as safely as possible.
The Michigan Nurses Association is in full support of establishing
the governor's commission on patient safety and will work with you
to pass this legislation. We look
forward to the opportunity to serve on the commission to improve
the quality of health care for Michigan's residents.
Thank you for your time.
SOURCES:
Study 1: "America's Nurses Cite Higher Pay, Improved Staffing
as Top Solutions to Shortage," www.uannurse.org/uan/pressrel/2003/0116.htm.
Study 2: "Study: Nursing shortage deadly," www.phillycom/mid/philly/news/4348771.htm.
Study 3: "Study Reveals Link Between Increased Nursing Care,
Better Patient Outcomes in Hospitals, " www.nursingworld.org/pressrel/2002/pr0529.htm.
Study 4: Aiken LH, Clarke SP, Sloane DM, et al. Hospital nurse
staffing and patient mortality, nurse burnout, and job dissatisfaction.
JAMA. 2002;288:1987-1993
Study 5: Needleman J , Buerhaus P, Mattke S, et al. Nurse Staffing
Levels and the Quality of Care in Hospitals. NEJM 2002;234:1715-1721
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