October 7, 2014

Massachusetts ICU Staffing Law Takes Effect

CANTON, Mass., Oct. 1, 2014 /PRNewswire-USNewswire/ --  Beginning this week, critically ill patients in Massachusetts hospitals will be guaranteed safer care and closer monitoring from registered nurses as a new law goes into effect that sets safe patient limits for registered nurses who work in all the state's hospital intensive care units. The law requires that no nurse can be assigned more than one patient or in certain circumstances, a maximum of two patients based on the assessment of the nurses on that unit.

Massachusetts Nurses Association logo

The new law, An Act Relative to Patient Limits in All Hospital Intensive Care Units, was signed by Governor Deval Patrick on June 30 after passing with unanimous votes in the House and Senate and becomes effective as of Sept. 29, 2014, 90 days following the signing.

"This is an important patient safety measure for the most critically ill patients providing them with one-on-one attention from their registered nurse when they need it most," said Donna Kelly-Williams, RN, president of the Massachusetts Nurses Association/National Nurses United. "It is important for the public to be aware of this new measure as their health and safety in the hospital is directly related to the number of patients assigned to their nurse."

To help educate the public about the new law, the MNA/NNU has launched a TV and radio ad campaign to alert the public about the law and to advise them to ask how many other patients their nurse is being assigned To view the ad, go to: http://youtu.be/LzGRSeINt9g

The law was passed in response to dozens of research studies that clearly show safe maximum patient limits for nurses is the key to improving the care and safety of patients, leading to fewer patient complications, shorter hospital stays, lower readmission rates and higher patient satisfaction, while also saving millions of dollars due to these improved patient outcomes. In fact one study found that safe patient limits like those required under this new law, could reduce hospital acquired infections for ICU patients by 63 percent.

What the Law Does

  • The new law applies to every type of intensive care unit in all the state's hospitals, including medical intensive care units, surgical intensive care units, coronary care units, neonatal intensive care units and pediatric intensive care units.
  • The law sets a maximum limit of one patient per nurse. A nurse can only take a second patient based on the assessment of the staff nurses on the unit and a soon to be developed acuity tool. The acuity tool will have standardized criteria to help determine the stability of the patients and all hospitals will be utilizing the same criteria. Until the acuity tool is developed, the staff nurses on the unit will determine if and when a second patient can be assigned, and if they can't agree, then a supervisor or manager can be called in to help make the determination. In no instance and under no circumstances can an ICU nurse be assigned a third patient.
  • The state's Health Policy Commission (HPC) is regulating the implementation of the proposed law, including the formulation of the acuity tool, the method of public reporting of staffing compliance in hospital ICUs, and the identification of three to five patient safety quality indicators. The HPC has scheduled a Listening Session in Boston on Oct, 29 to gather testimony from nurses, hospitals and others to assist them in fleshing out the final regulations for the acuity criteria, reporting and compliance under the law and the quality indicators that will be measured.

Law Sets Foundation for Expansion of Limits to Other Units

"This measure will protect the most critically ill patients and it breaks the decade-long logjam on Beacon Hill over the issue of establishing an enforceable maximum limit on the number of patients a nurse can care for at one time," said Kelly-Williams.  More importantly, it moves us closer to our ultimate goal, which is to extend safe patient limits beyond the ICUs to all other units of our hospitals to protect every patient."Having established a foundation for safe patient limits for intensive care units with the new law, the MNA/NNU plans to introduce legislation to extend patient limits to all other hospital units in the next legislative session.

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