Feds may require staff, infection rate disclosures
Feds may require staff, infection rate disclosures
Bill may be harbinger for health care institutions
Congress would require hospitals to disclose staffing levels and nosocomial infection rates under a bill proposed this year by Rep. Maurice Hinchey (D-NY). The Patient Safety Act of 1996 (H.R. 33355), which would make hospital data accessible to the public, did not wind its way through the appropriate committees, but will likely be reintroduced if Hinchey is re-elected this month.
The bill which may be a harbinger of subsequent congressional action on the issue cites the following key concerns and proposed requirements, which are summarized as follows:
• Increased and growing public concern has been expressed regarding the quality and safety of services provided by health care facilities and institutions, as such facilities have instituted aggressive efforts to reduce levels of staff who provide direct patient care services as a principal means of decreasing expenses.
• A growing body of data suggests a linkage between the number and mix of nursing staff and positive patient care outcomes, including the avoidance of patient death and injury.
• Many employees of health care facilities have expressed fear for their employment if they report unsafe conditions, including violations of state or federal law.
• Unprecedented consolidation among health care institutions has led to increasing concern regarding the effect of such activity.
Requirements: Disclosure of staffing and outcomes. Any provider under the Medicare program shall, as a condition of continued participation in such program, make publicly available information regarding nurse staffing and patient outcomes as specified by the Secretary of Health and Human Services. Such information shall include at least the following:
• The number of registered nurses providing direct care. This information shall be expressed both in raw numbers, in terms of total hours of nursing care per patient (including adjustment for case mix and acuity), and as a percentage of nursing staff, and shall be broken down in terms of the total nursing staff, each unit, and each shift.
• The number of licensed practical nurses or licensed vocational nurses providing direct care. This information shall be expressed both in raw numbers, in terms of total hours of nursing care per patient (including adjustment for case mix and acuity), and as a percentage of nursing staff, and shall be broken down in terms of the total nursing staff, each unit and each shift.
• Numbers of unlicensed personnel utilized to provide direct patient care. This information shall be expressed both in raw numbers and as a percentage of nursing staff and shall be broken down in terms of the total nursing staff, each unit, and each shift.
• The average number of patients per registered nurse providing direct patient care. This information shall be broken down in terms of the total nursing staff, each unit, and each shift.
• Patient mortality rate (in raw numbers and by diagnosis-related group).
• Incidence of adverse patient care incidents, including at a minimum incidents such as medication errors, patient injury, decubitus ulcers, nosocomial infections, and nosocomial urinary tract infections.
• Methods used for determining and adjusting staffing levels and patient care needs and the provider’s compliance with these methods.
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