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Safe Patient Limits Initiative Inches Forward in MA

Alexandra Wilson Pecci, for HealthLeaders Media, September 17, 2013

The Massachusetts Nurses Association is waging a battle against unsafe patient loads. Now it is behind a petition drive to get a Patient Safety Act on the 2014 statewide ballot.

When I worked in an after-school program in Massachusetts we were always being reminded about the state's mandated child-to-staff ratios. If we were ever fell out of ratio—meaning there were too many kids per each adult—the daycare center could get into serious trouble with the state.

In Massachusetts, the staff-to-child ratio for infants is 1:3; it's slightly higher for older toddlers. And these children are healthy. But do nurses in Massachusetts have the same such limits for sick patients? No.

"I have heard from nurses on medical/surgical unit taking up to eight or nine patients" at a time, says Donna Kelly-Williams, RN, president of the Massachusetts Nurses Association. Research, however, shows these nurses should have no more than four patients at a time, she says. That's a big difference.

Loading up nurses with too many patients jeopardizes patient care incrementally. For instance, Kelly-Williams says that medical/surgical nurses should have no more than four patients at a time, and each additional patient after four compounds the chance of patient injury by 7%. That means that the fifth patient compounds injury risk for the other four patients by 7%; the sixth patient compounds the risk by 14%, and so on.

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