Tag Archives: patient safety

Important Update on Concern For Safe Staffing Forms

30 Mar

Below is a letter from the nurses serving on MNA’s Economic and General Welfare Commission:

Greetings to you all. We are writing to bring you up-to-date information about the safety of patients and the on-line Concern for Safe Staffing (CFSS) process. It has been a year since we went live with our streamlined process, and we want to apprise you of the success nurses have had documenting their advocacy for patients in unsafe staffing situations.

The CFSS process is an organizational initiative to standardize our reporting across the entire organization. The most important aspect of the process has evolved from filling out a form to mobilizing and encouraging action at the first hint of an unsafe situation. The online form documents the advocacy each nurse or multiple nurses took to notify managers of their concern. Nurses have been successful with repeated calls and initiating calls for subsequent shifts coming in, knowing the dilemma other nurses will be facing. Reliance on retrospective data is not fixing the problem. The employers need to listen and respond at the time a concern is raised. We need to document the positive responses and changes as well as the empty promises. “If it’s not documented, it’s not done.”

The online form helps us track the action nurses are taking “in the moment” of the staffing crisis, as well as the response from the manager. The E and GW Commission will, therefore, be requiring all bargaining units to utilize this process and we need your help to educate and advise other members. Please discard your old forms and make sure to print a copy of your CFSS form for your manager to formalize the fact that you took action.

Streamlining our process to focus on documenting the moment of advocacy permits us to do what we need and want to do with the information. This puts the nurses in control and ensures the employers cannot manipulate the information and disregard its importance. Don’t get caught up in the management arguments about not getting a form or MNA changing the process without their consent. We are frontline staff nurses and we know when we are working short, we communicate safety issues and do not need to justify our belief to management over and over again.

During the past six months, our trending shows that in 91% of the reported incidents, nurses have had no assistance from management with staffing concerns. The data does reveal nurses get the adequate resources 9% of the time. We believe there is more to report regarding the actions taken to resolve the unsafe staffing condition.

When nurses say it’s unsafe, the resources should be provided. We don’t want only negative management responses to be documented; we want to know more about the positive responses from management when they occur so we can discover what works and replicate it.

E and GW Commissioners will be calling the Chairperson(s) and Stewards of every facility to evaluate how the use of the CFSS process is functioning and how we can facilitate reaching all members on this crucial issue. Please help us help you and the patients we care for by using the on-line CFSS process.

MNA Legislative Update: National Nurse Licensure Compact Bill

6 Mar

MNA and NNU RNs turned out last night to testify in opposition to the proposed National Nurse Licensure bill.

Act Now:  Contact your legislator through MNA’s Grassroots Action Center

Last night the Senate Health and Human Services Committee heard the National Nurse Licensure Compact Bill. In 2011, Gov. Mark Dayton removed or vetoed the National Nurse Licensure Compact language from the Health and Human Services Omnibus Bill. When asked “What’s different this year? What concerns of the Governor’s have been resolved?” the chief author, Senator Chris Gerlach (R) from Apple Valley, responded by stating there are more supporters this year. At first glance, one can tell that the growing number of supporters is corporations as this would make it possible for corporations to bring in nurses from other states who have differing, or lower standards for nursing care than Minnesota nurses.

The Minnesota Nurses Association opposes the National Nurse Licensure Compact because:

  • It will offer Minnesota nursing jobs to non-Minnesota nurses.
  • It forces Minnesota to relinquish local control of nursing practice to an appointed National Board of compact administrators.
  • It puts patients safety at risk in multiple ways.

MNA President Linda Hamilton, Vice President Bunny Engeldorf and NNU President Jean Ross all testified last night in opposition to this bill.

Minnesota Nurses stand ready and willing to work with the Minnesota Board of Nursing and employers to explore Tele-health/Tele-nursing issues to address patient continuity of care. However, MNA nurses remain firm in their belief that National Nurse Licensure is NOT the answer for Minnesota.

The committee voted and passed the bill out of committee on a party line vote. The bill now moves to Senate Finance. If the bill moves to the Senate floor you will be contacted to call your legislator and ask them to vote “no” to protect Minnesota jobs, our state’s rights and to protect patient safety.

Finally, the audio/video archived hearing information and link with be posted as it becomes available. Stay tuned to the MNA Blog for more updates!

Breaking News on Important Legislative Issue: National Nurse Licensure Compact

5 Mar

Last Friday you received an email notifying you about the hearing on the National Nurse Licensure Compact (SF230, also known as the Interstate Nurse Licensure Compact) scheduled for today in the Minnesota Senate. We have gotten more specific information on the timing of the hearing: the Compact will be last on the agenda for the hearing, and we have been told by Health and Human Services Committee staff to expect the compact to come up sometime between 5:00 and 6:30 pm tonight. Schedules at the Legislature are very fluid and things may change, so we can’t give you an exact start time, but we believe that if you arrive by 6:00 pm you will be there in time to hear the discussion. MNA President Linda Hamilton will testify in opposition to National Nurse Licensure.

What: National Nurse Licensure Compact Hearing, Senate Health and Human Services Committee

Where: Room 15, Minnesota Capitol (ground floor, directly below Rotunda)

When: Between approximately 5:00 and 6:30 pm

Why: The Compact is supported by the Long-term Care Industry and other Health Care Corporations.  MNA STRONGLY OPPOSES this controversial legislation because of the risks it poses to patient safety, our nursing practice, and to our union.

Many of you have asked about parking at the Capitol. The closest public parking will be at meters on John Ireland Blvd (in front of the Department of Transportation Building), Rev. Dr. Martin Luther King Blvd (between the Judicial Center and the Centennial Building) and Cedar Street (in front of the Centennial Building). Parking meters take quarters only (one quarter = 12 minutes) but meters aren’t enforced after 4:30 pm. Click here for information about visiting the Capitol.

Why does MNA oppose National Nurse Licensure? 

Threats to Nursing Practice
The compact is a radical change in how we regulate nurse licensure in our state today. It would allow nurses to practice within our state without a MN license.  This bill could result in a “race to the bottom” as nurses without the same licensure standards or requirements would be allowed to work side- by- side with MN nurses. We believe the regulation of Nurse Practice is a States’ Right Issue and this bill would give the NCNBS (National Council of State Boards of Nursing) control over Minnesota’s nursing practice without public accountability.

Threats to Patient Safety
No evidence exists that entering into an Interstate Compact improves patient safety. In fact, a recent investigation of 5 compact states by Propublica, an investigative journal, found four dozen examples of nurses who continued to work even though another compact state had barred them. Their licenses were suspended for a number of issues including ignoring patients’ needs, stealing medications, and missing crucial tests or changes in a patient’s condition. The Compact may actually multiply the risk to patients because the Compact impedes the state’s ability to ensure non-resident nurses fulfill the same qualifications for practice that are expected of resident nurses.

Threats to Our Union
The Compact also poses a threat to our union. It allows multistate corporations to move nurses across state lines under the regulatory radar. We believe the compact would cause potential disruption by out-of-state nurses on our contract negotiations and union action and that employer intimidation and discipline of nurses advocating for their patients could increase under the compact. Without a state licensure system, the thousands of nurses who crossed our picket lines this summer would not pay a licensure fee nor could they be easily tracked by our BON.

 

Press Release: MNA RNs Introduce 2012 Staffing For Patient Safety Act

28 Feb

UPDATE: Watch Video of the Press Conference

FOR IMMEDIATE RELEASE
Media Contact: John Nemo, MNA, 651-414-2863 or john.nemo@mnnurses.org

ST. PAUL (February 28, 2012) – Armed with new – and disturbing – evidence gathered from the front lines of hospitals across the state, Minnesota nurses introduced legislation today aimed at addressing patient safety through adequate staffing levels.

“We have nearly 1,000 incidents from the final six months of 2011 where our patients suffered and in some instances even had their lives put at risk because of inadequate staffing levels,” said Minnesota Nurses Association President Linda Hamilton, RN. “What’s even more disturbing is that in nearly 900 of these incidents, hospital management did not – in the professional opinion of our Registered Nurses – take adequate steps to remedy the situation. That means hospital administrators failed patients and nurses more than 90 percent of the time whenever patient safety issues were brought to their attention.”

MNA Nurses filled out 988 Concern For Safe Staffing (CFSS) forms during the final six months of 2011 after a new online reporting system was formally launched on the MNA website and mobile application. Copies of each CFSS form were submitted to both hospital management and MNA representatives. Of those documented incidents, 54 percent put patient safety at “High” or “Extreme” risk, according to the professional judgment of MNA RNs.

“Unfortunately, these numbers don’t represent a new problem or a new pattern of hospital administrators failing to act,” Hamilton said. “After years of broken promises from hospitals to work directly with nurses to address patient safety issues that resulted from inadequate staffing, we’ve been left with no choice but to take our concerns to the state legislature. And we’re pleased this proposed legislation has the bipartisan support of Rep. Larry Howes in the House and Sen. Jeff Hayden in the Senate.”

The 2012 Staffing For Patient Safety Act includes setting a maximum patient assignment for Registered Nurses based on factors including nursing intensity and patient acuity, and would require hospital administrators to work directly with nurses to ensure that adequate resources are provided to keep patients safe. It would also increase transparency surrounding the staffing process.

“Hospital administrators have said for years that they’re willing to work with nurses and allow us – based on our own professional judgment – to add staff in an appropriate and timely manner when our patients are not safe,” Hamilton said. “That simply hasn’t happened. And until it does, we need legislation like this to hold hospital administrators accountable and keep our patients safe.”

On June 10, 2010, 12,000 Minnesota RNs conducted the largest nursing strike in history to call attention to patient safety issues resulting from inadequate staffing in the Twin Cities and beyond. As part of the ensuing contract settlement, 14 of the state’s biggest hospitals once again promised to work directly with nurses to ensure patient safety through adequate staffing levels.

Nearly 18 months later, the problem is worse than ever inside numerous hospitals across the state, according to Hamilton. Instead of keeping their word, Minnesota hospital executives even went so far as to secretly plan a three-year long PR campaign aimed at stonewalling any attempts by nurses to address patient safety through adequate staffing. The plan was uncovered in late 2010 after MNA nurses learned of a Minnesota Hospital Association (MHA) memo outlining the strategy. (Visit www.mnnurses.org/Memo for complete details.)

“This is not some sort of game,” Hamilton said. “We’re talking about real people here. Real families. We had one recent example where a nurse was caring for a dying baby, but was forced to take another patient because the unit wasn’t staffed adequately. That meant this nurse was severely limited in her ability to comfort the grieving family. To begin with, a dying baby should never be paired with another infant. On top of that, think of what this must have been like for the parents of the dying child. And you know what management did in response? They ordered pizza for the nurses.”

In addition to the documented personal stories and experiences shared by MNA RNs on the front lines, there are dozens of national studies and statistics proving the direct connection between adequate RN staffing levels and patient safety, Hamilton said, noting that in hospitals with inadequate staffing conditions:

(Please visit www.mnnurses.org/StaffingStudies for a comprehensive list of all relevant studies and findings related to RN staffing levels and patient safety.)

“Keeping our patients safe through adequate staffing levels is the one issue that every single nurse at every single hospital in the state of Minnesota and across this country can relate to,” Hamilton said. “Our hospital executives can spend millions of dollars on PR campaigns and point to industry awards as evidence that staffing is adequate, but their rhetoric doesn’t match the reality of what’s happening inside too many of our hospitals. This legislation is an important step, one we hope brings about the transparency and teamwork we need to solve what can literally be a life and death issue for our patients.”

Founded in 1905, the Minnesota Nurses Association (MNA) represents more than 20,000 nurses in Minnesota, Wisconsin and Iowa.  It is also a founding member of National Nurses United (NNU), which is the largest union of professional nurses in the United States, with more than 170,000 members. Learn more about MNA at www.mnnurses.org.

By the Numbers – Staffing inside Minnesota Hospitals
The following data was taken from the 988 Concern For Safe Staffing forms filled out by MNA RNs during the final six months of 2011:

A Sampling: Patient Safety Stories Shared by MNA RNs during 2011-2012
MNA Nurses fill out hundreds of Concern For Safe Staffing forms online each month. The stories below are just a few examples of how inadequate staffing conditions inside Minnesota hospitals continue to have negative – and sometimes even deadly – consequences for patients and nurses. (Note: Due to HIPAA privacy laws for patients, we cannot publicly identify the specific nurse, hospital and/or patient(s) involved in each story in this space.)

“A nurse on the unit with a dying baby was given another patient, severely limiting her ability to provide comfort to the family. Assignments were completely unacceptable. A patient who is dying should never be paired with another infant. I was unable to assist any of my co-workers and they were unable to assist me. Nurses did not get breaks, although (pizza) was ordered by management as a consolation. We want more nurses, not food! Our patients deserve quality care and they are not getting it!”

“We did have one patient fall, with significant injuries. This could have been avoided with adequate staffing. None of the nurses were able to take any kind of a break. Our patient census (count) and acuity (how sick they were) was very high!”

“One patient was impulsive and confused and was constantly trying to crawl out of bed. I had to constantly check on this patient to ensure that he did not climb out of bed. I was also taking care of a patient in same unit who was a high fall risk and extremely impulsive, and who was hospitalized due to a fall. The bed alarm did not work on this patient’s bed. At one point in my shift, when I was across the hallway in the other confused patient’s room, I saw the first confused patient walk out into the hallway. It felt like I could not give this patient enough attention because I had to make sure that patients in the other unit were safe.”

RN Essay: The Numbers Don’t Lie – Safe Staffing Saves Lives

25 Feb

Bemidji RN Sandra K. Nye wrote an amazing essay – published in her area newspaper – recently on safe staffing levels. Please take a few minutes to read and consider what Sandra points out:

There is an alarming pattern of increased adverse events occurring in hospitals throughout the U.S., which includes medication errors, unnecessary deaths, patient falls, and hospital-acquired infections.

A direct relationship exists between the quality of nursing care and amount of time a Registered Nurse spends with each patient. These events are preventable by simply increasing RN numbers each shift. Nurses are the greatest defense for patient safety, so it is vital that safe RN staffing becomes a priority in hospital policy and budget.

Appropriate staffing saves lives! Decreasing RN numbers, in order to save money, decreases time spent with each patient and leads to more mistakes and lives lost. Inadequate staffing is a central reason for burnout and job dissatisfaction, which leads to inadequate patient care, injuries, infections and sometimes death.To decrease errors and death rates, most RNs prefer facilities to require managers to match RN staffing with patient needs, not numbers of patients. This would insure that patients receive quality care by RNs who can meet individual needs. RNs and Minnesota citizens should meet the political challenge and get involved in the legislative process, then we will see a greater response and action to safe RN staffing and save lives.

Patients deserve quality care, without fear of hospital-acquired infections, unmet needs, or delayed care by overworked RNs. The Minnesota Nurses Association (MNA) says, “Higher hospital occupancy, lower nurse staffing levels, … all independently increase risk of dying in the hospital.” The MNA also said, when RN staffing is higher, a hospitalized person is 68 percent less likely to acquire a preventable infection.

A Texas study of 1,300 bladder-cancer surgery patients showed increased RN staffing decreased death rates by 50 percent, according to a fact sheet from the MNA. This astounding example shows how assigning more RNs to provide care saves lives. If increasing RN staffing levels can save lives after bladder-cancer surgery, then it is sensible to presume increasing RNs staffing in other areas will also save lives.

The MNA appointed Anderson, Niebuhr & Associates to survey Minnesota citizens and learn what people thought about nurse staffing. They discovered 90 percent believe RN staffing is “insufficient” and “a threat to safe patient care.” In addition, 84 percent of experienced nurses, employed for 20+ years, affirm the nurse-to-patient ratio is too high and leads to higher death rates, infections, and other problems.

Make sure to know your representatives and vote for those who care about safe nurse staffing. Give them a call, and tell them you want safe RN staffing now, before you or a loved one suffers or dies at a hospital that does not provide adequate RN staffing. Increasing RN staffing does save lives.

 

Unsafe Staffing Story: I wouldn’t send my own family to the hospital I work at!

13 Feb

MNA Nurses fill out hundreds of Concern For Safe Staffing forms online each month. The story below is just one example of how unsafe staffing conditions inside Minnesota hospitals continue to have negative – and sometimes even deadly – consequences for patients and nurses. (Note: Due to HIPAA privacy laws for patients and concerns for potential workplace retaliation by employers against RNs, we do not identify the specific nurse and/or patient(s) involved in each story in this space.)

Today’s Story: I don’t feel patients are being safely monitored on this unit. With all the cardiac, respiratory, fall risk, and incontinence issues that the majority of  cardiacpatients have; it’s not safe for one nurse to adequately monitor 6 patients. I wouldn’t want my family or loved ones to be there, and I can’t recommend our unit to anyone that asks how the care is at [my hospital].

More information:

Unsafe Staffing Story: Too Many Babies, Not Enough Nurses

10 Feb

MNA Nurses fill out hundreds of Concern For Safe Staffing forms online each month. The story below is just one example of how unsafe staffing conditions inside Minnesota hospitals continue to have negative – and sometimes even deadly – consequences for patients and nurses. (Note: Due to HIPAA privacy laws for patients and concerns for potential workplace retaliation by employers against RNs, we do not identify the specific nurse and/or patient(s) involved in each story in this space.)

Today’s Story: Charge nurse had 3 moms and 2 babies; one requiring constant help with newborn cares and breastfeeding. One staff nurse had 5 moms and 5 babies, including a new Caesarean birth and a new vaginal delivery with significant postpartum hemorrhage. Another nurse had 5 moms and 5 babies-  2 mothers requiring constant help with breastfeeding and 2 babies requiring bottle feeding every 2-3 hours. One nurse had 4 moms and 4 babies including a new C-section birth with MRSA precautions and a non-English speaking new vaginal delivery. Nursery RN was a  casual staff member with 3 babies under her care most of the shift.

More information:

Must Read: A Dying Baby, Not Enough Nurses … Hospital Management’s Response? Order Pizza!

8 Feb

MNA Nurses fill out hundreds of Concern For Safe Staffing forms online each month. The story below is just one example of how unsafe staffing conditions inside Minnesota hospitals continue to have negative – and sometimes even deadly – consequences for patients and nurses. (Note: Due to HIPAA privacy laws for patients and concerns for potential workplace retaliation by employers against RNs, we do not identify the specific nurse and/or patient(s) involved in each story in this space.)

Today’s Story: The night shift was 7 nurses short so assignments were again increased. Requiring nurses to take additional patients to their already heavy loads was totally unsafe. A nurse on the unit with a dying baby was given another patient, severely limiting her ability to provide comfort to the family. I had a baby who would be finishing antibiotics, and then could go back to the newborn nursery, but I was unable to obtain any orders for transfer and required treatments during the shift, so the baby stayed in our unit under my care. (Later) I was notified that I would be getting a 35 week old admit and another patient who was on a ventilator and had a chest tube. This infant had (received) 1:1 care on the previous shift. I was unable to obtain any orders for the 35 week old infant for 1.5 hours because the providers (nurse practitioners) got called to two simultaneous deliveries of premature infants. Assignments were completely unacceptable. A patient who is dying should never be paired with another infant. I was unable to assist any of my co-workers and they were unable to assist me. Nurses did not get breaks, although (pizza) was ordered by management as a consolation. We want more nurses, not food! Our patients deserve quality care and they are not getting it!

More information:

Unsafe Staffing Story: Kids’ ICU Dangerously Thin on RN Staffing

1 Feb

MNA Nurses fill out hundreds of Concern For Safe Staffing forms online each month. The story below is just one example of how unsafe staffing conditions inside Minnesota hospitals continue to have negative – and sometimes even deadly – consequences for patients and nurses. (Note: Due to HIPAA privacy laws for patients and concerns for potential workplace retaliation by employers against RNs, we do not identify the specific nurse and/or patient(s) involved in each story in this space.)

Today’s Story: (From a hospital unit dealing exclusively with infants) - Working three nurses short in an Intensive Care Unit (ICU) is very unsafe. We have 17 vents [patients with ventilators, or machines that essentially breathe for patients and require continuous monitoring] and 21 acutely ill patients.

More information:

MNA President Linda Hamilton’s Response to Minnesota Adverse Events Report’s Release

26 Jan
MNA President Linda Hamilton

MNA President Linda Hamilton

Have you or a family member ever had the unfortunate experience of suffering from a pressure ulcer? In addition to being extremely unpleasant and painful, pressure ulcers can become so deep that they result in damage to your muscles, bones, tendons and joints.

And pressure ulcers – also commonly known as bedsores – are almost always preventable when proper staffing levels are adhered to.

Yet last week’s release of Minnesota’s Eighth Annual Adverse Events Report noted that incidents involving pressure ulcers spiked more than 19 percent statewide in 2011. What state hospital executives didn’t mention in spinning away that alarming statistic was that numerous national studies have shown a direct correlation between inadequate nurse staffing levels and an increase in conditions including pressure ulcers, pneumonia, upper gastrointestinal bleeding, shock/cardiac arrest, urinary tract infections and more.

The numbers don’t lie – safe staffing levels save lives and improve patient outcomes. While many will remember that the Twin Cities nurses’ strike during the summer of 2010 shined a white-hot spotlight on the issue, unsafe staffing has been a problem in Minnesota for decades.

As patients, you deserve better. You and your loved ones should never suffer without need from pressure ulcers, urinary tract infections or other conditions that can be prevented with adequate RN staffing levels.

Money is not the issue. Keep in mind that during the great recession of 2009, Twin Cities hospitals had their largest profit margins (6.5 percent) in a decade! It’s not that hospital executives can’t pay to adequately staff their hospitals. They just don’t want to.

My fellow nurses will continue to remain vocal about the needless suffering we in our patients see as a result. And data such as the recently released Adverse Events Report will continue to lend credibility and credence to our concerns.

Sincerely,

Linda Hamilton, RN
President, Minnesota Nurses Association

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