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2014 WSNA
Legislative
Priorities
WSNA Legislative & Health Policy Council
http://bit.ly/1bZYmbb
WSNA Legislative and Health Policy Council
Chair
Edward Dolle, RN - Port Orchard
Members
Barbara Bly, BSN, RN - Everett
Patty Hayes, RN, MN – Seattle
Justin S. Gill, RN – Blaine
Susan E. Jacobson, RN CCRN – Yakima- WSNA President, Ex-Officio
Lynn Nelson, RN, MSN - Olympia
Bobbi S. Woodward, RN - Spokane
Lynnette K. Vehrs, MN, RN – Spokane
WSNA Staff
Judy Huntington, MN, RN, Executive Director
Anne Tan Piazza, Assist. Executive Director of Governmental Affairs & Operations
Sofia Aragon, JD, RN, Senior Governmental Affairs Advisor
Richard Burton, Ph.D., Political Action Coordinator
Melissa Johnson, JD, Contract Lobbyist
Kate White Tudor, JD, Contract Lobbyist
Nursing leadership in demand
Robert Wood Johnson Foundation survey from
January 20, 2010 findings:
• From opinion leaders in insurance, corporate,
health services, government and industry
• Nursing could have the most influence on:
reducing medical errors (51%), improving
quality of care (50%), and coordinating patient
care in the health system (40%)
Opportunities and Challenges
in Nursing
Hospital errors are the 3rd leading
cause of death in the US
HEROES’ TOOLS
What nurses need to care for patients
HEROES -- Nurses who work hard
and look out for their patients
•Rest breaks– so that nurses can
be sharp when it counts
•On-call only for emergencies
•Safe staffing standard: setting a
maximum number of patients per
nurse
Lack of breaks and on-call abuse cause fatigue, jeopardize patient
safety, and drive people out of nursing.
57% of nurses
believe that lack of
breaks, call
requirements, and call
back hours are causing
nurse fatigue and
jeopardizing patient
safety at their hospital
Lack of breaks and on-call abuse cause fatigue, jeopardize patient
safety, and drive people out of nursing.
50% of nurses say
that a lack of breaks and
concern for patient
safety has caused
someone they know to
leave their unit or
profession, or it has
caused them to consider
doing so themselves
House Bill 1153
On-Call Nurses are for Emergencies Only
• Forced overtime causes
fatigue and isn’t safe
• prevents hospitals from
scheduling nonemergency procedures
that require forced
overtime
• Limits prescheduled oncall
Real Breaks Keep Patients Safe Bill
HB 1152
• Nurses intercept 86% of
medical errors before
there is harm to
patients
• Real breaks mean
better care
• We can still put our
patients first
• Allows interrupted for
clinical circumstances
that could lead to
patient harm
• Is flexible
• Hospitals to work with
staff RNs to make it
work
Nurses have seen understaffing harm or kill
patients, and many see it as a chronic problem.
45% of nurses who
have experienced
understaffing
threatening care say
the problem occurs
often
41% who have
encountered the issue
only once or twice
Many nurses don’t believe their staffing committees, as
currently formed, are effective in setting staffing levels.
41%
of nurses say
that their
staffing
committees are
not effective in
setting staff
levels
Nurses strongly support a law to set minimum staffing
levels for patients.
82%
of nurses favor “a
proposed law
that would set
minimum nurse
to patient staffing
ratios in each
hospital unit”
Patient Safety Standard Bill
HB 1095
• A standard keeps patients safe
• The Facts Show: Patient Safety Standards Work
– Every year, up to 400,000 patients die from preventable
medical errors – as many as 4 plane crashes every day.
– By adding just one more full-time RN per day, hospitals
decreased the number of deaths in ICU’s by 9% and in
surgeries by 16%.
– A standard has already been implemented in California, and
they’ve seen an 11-14% drop in post-surgical patient deaths.
Patient Safety Standard Bill
HB 1095
• Safety Standards - Establishes minimum statewide staffing standards,
maximum number of patients per nurse.
• Customization - Uses the current nurse staffing committees at each
hospital to tailor staffing plans to the specific needs of each unit.
• Authority - Mandates that hospitals must implement the staffing plan
approved by the nurse staffing committees above the minimum standard.
• Professional Judgment - Ensures that RNs are not assigned to other units
without training and competency evaluation.
• Transparency - Collection and public disclosure of specific nursing sensitive
patient outcomes data.
• Accountability - Prompt investigation of staffing complaints, corrective
action required for violations with a potential civil penalty of $10,000 for
violation.
A Challenging Political Landscape
•
•
•
•
New Inslee administration
Shift in Power in the Senate
Revenue is flat
McCleary decision – funding for K-12
Budget Crisis
Budget Crisis
Budget Priorities
• School nurses
• Nursing education funding
– Enrollment slots/scholarships
– Faculty recruitment/retention
• Public health funding
– Maternity Support Services
• Continue enhanced primary care
reimbursement for ARNPs to provide
care under health reform.
School Nurses
• Health needs are increasing among WA K-12
students
• Because there are not enough school nurses,
personnel without any health care license are
under pressure to administer risky medication.
Examples are seizure medications and stock
epinephrine
• The good news is that legislators are looking
for ways to increase the number of school
nurses.
A Persistent Nursing Shortage
• demand will outpace supply in Washington
over the next decade as RNs begin to
retire and demand for health care
escalates.
• The gap between RN practicing supply
and demand will be more than 12,000 RNs
in 2031, even under the most optimistic
scenario. WWAMI Center for Health
Workforce Studies
Nurse Educators wanted!
• An estimated 23% of nurse educators retired in 2012
and increased demand for nurses is estimated to
persist through 2030.
• The gap between the salaries in practice and
education have created a shortage of nurse faculty.
• Nursing programs will not be able to provide
adequate opportunities.
• Advocate for affordable tuition for RN and advanced
practice nursing programs
• Advocate for the Health Professions Scholarship
Fund.
Opportunities for Advanced Registered
Nurse Practitioners
• 2012 survey: 38% WA ARNPs
in family practice
• ARNPs and P.A.s are 40% of
primary care providers
• WA allows ARNP
autonomous practice. This
is critical to ensure access to
care
• WA Legislature must sustain
an enhanced reimbursement
for ARNPs proving primary
care under the Medicaid
expansion.
Vote Yes for HB 1538
Public Health Nurse Dispensing
• Current practice only allows public health nurses to
dispense medication under a provider with
prescriptive authority
• HB 1538 allows public health nurses to dispense
medications for the purposes of communicable
disease control and family planning
• A coalition effort: in collaboration with DOH, WA
State Association of Counties, local public health, and
public health nurses to affirm this practice
• Politically sensitive
The Nurse’s Voice in Environmental
Health Policy
2014
Implementing Florence Nightingale’s
Tenets to Protect Children, Families
and Communities
Historical Perspectives of Nursing and
Political Activism
Nurses and Environment Health
• The American Nurses
Association
• Washington State Nurses
Association
• Health Care Without
Harm and the Nurses
Work Group
• The Alliance of Nurses for
a Healthy Environment
Nursing: Scope and Standards of Practice:
Standard 16 - Environmental Health
• Standard 16. Environmental Health states that: The registered nurse
practices in an environmentally safe and healthy manner.
• It is based on ANA’s Principles of Environmental Health for Nursing
Practice
• Knowledge of environmental health concepts is essential to
nursing practice.
• The Precautionary Principle guides nurses in their practice to use
products and practices that do not harm to human health or the
environment and to take preventive action in the face of
uncertainty.
• Nurses have a right to work in an environment that is safe and
healthy.
Ballard, Karen (2013) Environmental Health and ANA’s
Standards of Nursing Practice: 101
Nursing: Scope and Standards of Practice:
Standard 16 - Environmental Health
• Nurses participate in assessing the quality of
the environment in which they practice and
live.
• Nurses, other healthcare workers, patients,
and communities have the right to know
relevant and timely information about the
potentially harmful products, chemicals,
pollutants, and hazards to which they are
exposed.
Safety & Environmental health
• Child Safe Products
Act
• PBDE Bill
• Safe Baby Bottle
Act
• E-Waste Bill
Children’s Safe Product Act 2008
• Set limits on cadmium, phthalates and lead in
children’s products
• The Reporting List of Chemicals of High
Concern to Children (CHCC)
http://www.ecy.wa.gov/programs/swfa/cspa
/chcc.html
(ESHB1294)
Our children deserve to inherit a
safe and healthy world
Today our homes, bodies, and environment are
contaminated with cancer-causing toxic flame retardants
that escape from foam products in our homes, like
couches, changing pads, nursing pillows and car seats.
www.watoxics.org
What the Toxic Free Kids and Families
Act Will Do
• Bans all (6) toxic flame retardants found
on the “List of Chemicals of High Concern
for Children”
• Prevents makers of children's products
and home furniture from replacing banned
flame retardants with other toxic flame
retardants.
• Exempts children's products/home
furniture from the ban if there’s no safer
alternatives available.
• Ensures compliance with the law by
allowing the Dept. of Ecology to request
certificates of compliance from products
makers.
(
This is Needless Exposure to Toxic Flame
Retardants
•The amounts of ineffective but toxic flame
retardants is not PPM but rather ounces and
pounds.
•There are safer alternatives like a thin layer of wool
Tell Your Legislators to Vote Yes for
ESHB1294 because…
• They don’t work
• Safer alternatives
• Supported by
firefighters
• Protects children,
family members and
pets
• Gets us off the
Toxic Treadmill
Health
+
Environment
Nurses…
put it back
together
Nurses Lead Where We Stand
“We assume most men and women choose to
become nurses because they want to help
people live well. Our hope is that they will see
the unlimited possibilities of nursing to change
the world."
- Melanie C. Dreher, PHD, RN, FAAN; Dolores J. Shapiro, PhD, RN; and Micheline Asselin, MPA, MSN, RN, CHPN, co-authors, Healthy
Places, Healthy People: A handbook for culturally competent community nursing practice (Sigma Theta Tau International 2006)
Nursing’s power for a better future
• Largest health care workforce in the state and in the
nation with 85,000 registered nurses in WA and 3
million nationwide.
• Nurses are instrumental in realizing health reform, to
transform its health care system
• Nurses are at the front lines
• Nurses practice in many settings, including hospitals,
schools, homes, retail health clinics, long-term care
facilities, battlefields, and community and public health
centers
• There are barriers: regulatory, business, organizational
conditions
What You Can Do
• Talk to your legislator in Olympia today!
• Fill out the Patient Safety Reform flyer to leave
behind with your Legislators
• Write a letter/send an e-mail/call their office
– Legislative Hotline 1-800-562-6000 or e-mail your
legislator at www.leg.wa.gov
• Watch WSNA e-mail action alerts
• Check wsna.org for updates
• Staff contact: [email protected]
A convenient meeting place