THE SENATE

S.C.R. NO.

140

TWENTY-SECOND LEGISLATURE, 2004

 

STATE OF HAWAII

 
   


SENATE CONCURRENT

RESOLUTION

 

requesting the legislature to convene a task force to make recommendations on the nursing shortage, nurse staffing levels, acuity systems, and other related factors in order to ensure patient safety in health care facilities.

 

WHEREAS, there is increasing concern about the effect of inadequate nurse staffing on patient care; and

WHEREAS, studies show that the health of patients is directly proportionate to the number of registered nurses working in hospitals or health care facilities; and

WHEREAS, several recent research studies funded by the federal government have made a correlation between inadequate nurse staffing and poor patient outcomes; and

WHEREAS, one study published in the Journal of the American Medical Association indicated that, for each patient that a nurse on a medical-surgical unit must care for in excess of four, there is a corresponding seven percent increase in the death rate; and

WHEREAS, assessment and timely intervention conducted by skilled registered nurses is so critical to a patient's well-being that it has led to the introduction of a new term called "failure to rescue"; and

WHEREAS, Hawaii suffers from a nursing shortage that is expected to become critical in the next ten years, especially due to our ever increasing population of patients over the age of eighty; and

WHEREAS, there is already a critical worldwide shortage of registered nurses making it more difficult for Hawaii to recruit and retain registered nurses from abroad, a strategy which has been utilized in the past; and

WHEREAS, in 1980, the average age of a nurse was 47.1; and

WHEREAS, currently, on the mainland, 68.3% of all nurses are over the age of forty; and

WHEREAS, the Hawaii statistic is even higher than the statistic for mainland nurses, as the average age of a registered nurse in Hawaii is 48.7 years of age with 79.2% of Hawaii's nurses over the age of forty; and

WHEREAS, it is critical that the nursing profession replace nurses who retire, particularly in light of the fact that the number of nurses under the age of thirty is currently extremely low and has been decreasing for many years; and

WHEREAS, in 1999, the population of nurses nationwide under the age of thirty was 9.1%, whereas in 1980, the number of registered nurses nationwide under the age of thirty was 25.1%; and

WHEREAS, the situation in Hawaii is even more alarming when one considers the statistics for nurses under the age of thirty, demonstrated by the fact that in 1999, the number of registered nurses in Hawaii under the age of thirty was 6.3%, sinking to 5.7% in 2001; and

WHEREAS, one effect of the shortage may be unsafe staffing levels in hospitals and health care facilities; and

WHEREAS, the retirement of many nurses from the workforce, restructuring of the workforce, which has led to concern over patient safety and high levels of dissatisfaction in the current nursing workforce, the lack of interest in the profession, decreasing reimbursements to health care facilities, the high patient acuity, and a negative image and lack of respect for the profession are but a few of the numerous factors affecting the ability of hospitals and health care facilities to recruit and retain nurses; and

WHEREAS, as a consumer of inpatient and outpatient hospital services for individuals entitled to benefits under the Medicaid program, and as the party responsible for the inspection and licensing of health care facilities, the State of Hawaii has a compelling interest in ensuring that adequate numbers of nurses are available to provide safe patient care throughout the State; now, therefore,

BE IT RESOLVED by the Senate of the Twenty-Second Legislature of the State of Hawaii, Regular Session of 2004, the House of Representatives concurring, that a task force be convened to examine the issues arising from the current nursing shortage in Hawaii and to make recommendations to address the problems in a manner which will promote patient safety; and

BE IT FURTHER RESOLVED that the task force be comprised of the following:

(1) The Director of Health, or the director's designee;

(2) Six registered nurses involved in direct patient care, as follows:

(A) Three appointed by the Hawaii Nurses Association; and

(B) Three appointed by the Hawaii Government Employees Association;

Each appointing authority shall ensure that at least one of its appointees represents a specialty nurses association;

(3) Two clinical nurse specialists or nurse administrators, appointed as follows:

(A) One appointed by the Hawaii Nurses Association; and

(B) One appointed by the Healthcare Association of Hawaii;

(4) The Dean of the School of Nursing and Dental Hygiene at the University of Hawaii, or the Dean's designee;

(5) The President of the American Organization of Nurse Executives, or the President's designee; and

(6) Two representatives from the Healthcare Association of Hawaii, at least one of whom shall be a health care administrator;

and

BE IT FURTHER RESOLVED that the task force is requested to:

(1) Examine various acuity systems for reliability and validity and make recommendations based upon positive patient outcomes;

(2) Address issues related to safe staffing based upon the principles of safe staffing developed by the American Nurses Association;

(3) Consider cultural factors unique to the State of Hawaii;

(4) Work in conjunction with the Center for Nursing to create a pilot project to test various staffing systems; and

(5) Make any and all recommendations, including supporting rationale, available to the Legislature, health care facilities, and the public at large;

and

BE IT FURTHER RESOLVED that the task force is requested to submit its findings and recommendations, including the preparation and submission of any necessary and appropriate legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2005; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of Health, the President of the Hawaii Nurses Association, the Executive Director of the Hawaii Government Employees Association, the President of the Healthcare Association of Hawaii, the President of the American Organization of Nurse Executives, the President

of the University of Hawaii, and the Dean of the School of Nursing and Dental Hygiene.

 

 

 

 

 

 

 

 

 

OFFERED BY:

_____________________________

Report Title:

Patient Safety; Safe-Staffing Levels; Task Force