To: Tim Kaine

From: Caitlyn Crummett

10/26/17
Subject: S.1063 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2017

Healthcare in the US is a hot topic in society today, especially regarding cost and quality. Safety is a topic
that is important to myself and every healthcare provider I encounter. Prevention of falls, medication
errors, and healthcare acquired infections all fall under the umbrella of safety and quality. What each of
those topics have in common is that they are preventable. How can we create a safer environment for our
aging as well as sicker population? It requires a team. Lack of staff in the acute care setting has been a
problem for decades, Nurses are assigned patients and receive report on their patients and are expected to
know very specific details about each of their patients including their history like their own family.
Depending on the unit, the nurse to patient ratio is 1:5+ (5 being the average), and on critical care floors
1:1-2. These numbers depend on the acuity of care, the census of staff and patients on the unit etc. As a
student nurse, it is sometimes challenging enough when I have two patients to learn about, provide quality
care for, educate and so on and I constantly find myself perplexed at how new and seasoned nurses alike
find their balance, and practice safely. I’ve heard some state “You learn to make short cuts.” But what if
you make the wrong short cut and it becomes a potentially life-threatening issue?
Centers for Medicare and Medicaid Services won’t reimburse hospitals for “Never Events” which are
defined as “Errors in medical care that are of concern to both the public and health care professionals and
providers, clearly identifiable and measurable” (Kuhn, 2008). These are events such as pressure injuries,
falls, catheter associated urinary tract infections, and with more staff to collaborate with we can dedicate
more time to our patients to make sure these never events truly never happen therefore providing safer
and quality services.

 Increased nurse staffing reduces hospital readmissions which avoids unnecessary costs for the
patient and hospital, patient mortality, “Nurse fatigue” which means nurses will stay with their
organization longer and give their best efforts (Avalere Health LLC, 2015).
 For every patient a nurse added under her supervision for there was a 7% increase in patient
mortality (Kevin T. Kavanagh, 2012).
 From nurse to patient ratios of 1:4 to 1: 8 patients, increased the risk of mortality by 31% (Kevin
T. Kavanagh, 2012)
Recommendation: Vote to pass bill S.1063 - Nurse Staffing Standards for Hospital Patient Safety and
Quality Care Act of 2017. It is important to protect our neighbors and loved ones in times of need. By
supporting this bill, you are supporting nurses everywhere that give their best and want to see a world
where we never have to report a never event because we had the support we needed to take care of our
patients and work as a team. As a future nurse, safety and quality are standards that I hold myself and my
peers accountable for and if we can’t provide the safest care, then what are we doing?
 References
Avalere Health LLC. (2015, September). Optimal Nurse Staffing to Improve Quality of Care and Patient
Outcomes: Executive Summary. Retrieved from
http://www.nursingworld.org/DocumentVault/NursingPractice/Executive-Summary.pdf

Kevin T. Kavanagh, J. P.-B. (2012, December). Moving Healthcare Quality Forward with Nursing-Sensitive
Value-Based Purchasing. Journal of Nursing Scholarship, pp. 385-395.

Kuhn, H. B. (2008, July 31). Retrieved from Centers for Medicare and Medicaid Services:
https://downloads.cms.gov/cmsgov/archived-downloads/smdl/downloads/smd073108.pdf