Magazine article American Nurse Today

Transparency and Accountability in Nurse Staffing: Keeping the Public Informed about Staffing Benefits Patients

Magazine article American Nurse Today

Transparency and Accountability in Nurse Staffing: Keeping the Public Informed about Staffing Benefits Patients

Article excerpt

ORGANIZATIONAL TRANSPARENCY and accountability have come to represent efforts to measure and hold providers responsible for their actions through accessible and often comparative channels. Along with performance-based payment programs, both the Department of Health and Human Services and the Institute of Medicine have recognized transparency and accountability as key components to healing a US healthcare system that is inefficient, fragmented, and unsafe.

Nursing represents the largest healthcare segment and, according to ANA Nurses by the Numbers, close to 58% of RNs work in hospitals. The impact of transparency in nurse staffing on patient outcomes cannot be overstated. Research in the US and abroad continues to reinforce a relationship between low nurse staffing, missed care, and adverse outcomes (Needleman, 2016). For example:

* If a nurse is responsible for four patients and the care load is doubled, there is a 31% increase in the patient death rate. In patients who had complications, this rate is even higher. (Aiken et al, 2002)

* The higher the proportion of care provided by registered nurses, the shorter the length of stay in the hospital, the lower the rate of urinary tract infections and upper gastrointestinal bleeding, and the lower the rate of pneumonia, shock, cardiac arrest, and "failure to rescue." (Needleman et al, 2002)

* Nurses are responsible for 86% of all interceptions of medical errors. (Leape, 1995)

The Registered Nurse Safe Staffing Act

In April 2015, Senator Jeff Merkley (D-OR) and Representatives Lois Capps (D-CA) and David Joyce (R-OH) introduced into the House of Representatives the Registered Nurse Safe Staffing Act (HR 2083/S 1132). The bill would require Medicare-participating hospitals to develop a hospital-wide staffing plan for nursing services by using a committee composed of at least 55% of direct care nurses who are neither hospital nurse managers nor part of the hospital administration staff. …

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