To: Senator Tim Kaine

From: Morgan L. Tyner

Date: March 21, 2018
Subject: S.2446 Safe Staffing for Nurse and Patient Safety Act of 2018

It is well known that low nurse staffing leads to lower patient outcomes and satisfaction. This is a
serious problem for patients and nurses, as well as, our nation and our economy. I proudly
support S.2446 Safe Staffing for Nurse and Patient Safety Act of 2018 to ensure that Medicare
participating hospitals develop a staffing plan by a nurse-led staffing committee.
The rising costs of healthcare is associated with many factors correlated to lower nurse staffing,
such as: adverse events not covered by Medicare, patient readmission, hospital-acquired
infections and higher nursing turnover rates. All of these factors cost the U.S. billions of dollars
per year.
A nurse-led staffing committee could monitor and improve patient outcomes, as well as, lower
the cost of healthcare by preventing negative outcomes associated with a low nursing ratio.

 Nurses are critical in determining quality of care in hospitals and patient outcomes
(Wunderlich, Sloan, Davis, 1996).
 Thirty-day hospital readmission for pneumonia patients increases hospital stays 5-9 days,
increases mortality rates by 30-70%, and costs approximately $30,000 per patient
(Flanagan, et al., 2016)
 In 2011, 3.3 million people were readmitted to a hospital within 30-days, resulting in
$41.3 billion in total hospital costs (Hines, Barrett, Jiang, Steiner, 2014).

Recommendation: Vote to pass bill S.2446 Safe Staffing for Nurse and Patient Safety Act of
2018. Passing this bill can improve patient satisfaction and outcomes, alleviate unsafe working
conditions for nurses, and possibly lower the cost of healthcare by decreasing negative impacts
from low staffing. This bill could eliminate the pressure and stress nurses experience during low
staffing crises by ensuring safe staffing ratios.
Although I fully support this bill, I do recommend examining Sec. 1899 C(b)(3)(B)(ii) and
consider that the nurse-led staffing committee should review the hospital-wide staffing plan
quarterly, not annually. By applying this consideration, hospitals can properly analyze data on
staffing collected during each quarter. This enables the committee to study trends and
communicate more frequently about hospital staffing. The consideration to review the plan
quarterly can promote the hospital to be successful in the implementation process.
Please vote to pass this bill. This is a very important issue that needs to be recognized and
addressed immediately for the sake of patients, nurses, the economy and our nation.
 References

Flanagan, J., Stamp, K. D., Gregas, M., & Shindul-Rothschild, J. (2016). Predictors of 30-Day
Readmission for Pneumonia. Journal Of Nursing Administration, 46(2), 69-74.
doi:10.1097/NNA.0000000000000297
Hines, A., Barrett, M., Jiang, H., Steiner, C (2014). Conditions with the largest number of adult
hospital readmissions by payer, 2011. HCUP Statistical Brief #172. Agency for
Healthcare Research and Quality, Rockville, MD.
https://www.hcupus.ahrq.gov/reports/statbriefs/sb172-Conditions-Readmissions-
Payer.pdf
Wunderlich GS, Sloan F, Davis CK (1996). Nursing staff in hospitals and nursing homes: is it
adequate. Washington, DC: National Academy Press.
https://www.ncbi.nlm.nih.gov/pubmed/25121200