News Feature | August 14, 2013

Legislation To Mandate Patient Monitoring, Nurse Staffing Proposed

Source: Health IT Outcomes
Katie Wike

By Katie Wike, contributing writer

Patient Monitor

The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2013 intends to enforce minimum nurse to patient ratios and mandate available technology in order to provide the best care possible

The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2013, sponsored by Janice Schakowsky (D-IL) and referred to Committee in May, hopes to set a standard nurse to patient ratio for hospitals, amends the Public Health Service Act to require hospitals to implement a staffing plan that includes a minimum direct care registered nurse-to-patient ratio by unit, adjustments above the minimum ratio under appropriate circumstances, and compliance with minimum licensed practical nurse staffing requirements. According to EHR Intelligence, in addition to mandating minimum staffing levels, the proposed legislation also “considers factors affecting the delivery (of care) such as patient volume and the technology available to these caretakers.”

The Physician-Patient Alliance for Health & Safety (PPAHS), in announcing its support of the legislation, points to recent findings showing the importance of patient monitoring tools for nurses to succeed in hospital settings. EHR Intelligence quotes Julianna Morath, RN, MS, chief quality and safety officer at Vanderbilt University Medical Center, as saying, “Human vigilance is required but insufficient. Continuous electronic monitoring needs to be there to support and back up nurses and allow them to visit a patient while monitors are continuously assessing other patients for various physiological parameters.”

According to the PPAHS, a recent study showed nurses spend just 7.2 percent of their time assessing patients and taking vitals. Patient monitoring allows nurses to check on patients more frequently and more watchful monitoring gives nurses the ability to be in more places at once.

The PPAHS cites as example Kelowna General Hospital in British Columbia which “has been able to achieve better management of surgical patients with obstructive sleep apnea by bringing capnography monitoring (which assesses adequacy of ventilation) to the patient’s bedside.” It quotes Lynn Gerein, RN, BScN, network director, emergency and trauma services, interior health medical affairs and clinical networks, as explaining in an email, “Implementing this process has increased the capacity to monitor more patients with diagnosed sleep apnea and allow them to be recovered on the unit with the appropriately trained staff that aligns with their surgical needs.”

PPAHS continues, “Providing such a technological safety net beneath each patient has been shown to decrease or even eliminate adverse events. Since implementing continuous electronic monitoring of patients using patient-controlled analgesia pumps with integrated capnography monitoring, St. Joseph’s/Candler Hospitals has been ‘event free’ for more than eight years. Moreover, they have demonstrated that being patient safe provided a significant return on investment.”

Despite the studies cited above, GovTrack gives the bill no chance of getting past committee or being enacted. Only 11 percent of bills made it past committee and only about 3 percent were enacted in 2011–2013.