Out-of-state reform efforts
California became the first state to have a staffing-ratio bill signed into law. The original legislation called for numeric patient-to-staff ratios. The final version contains no such provision. Instead, by Jan 1, 2002 the state's Department of Health Services, not the nursing profession, is charged with promulgating regulations for staffing ratios.

New Hampshire addressed the staffing issue by requiring hospitals to report the number of RNs per bed. This approach puts public pressure on hospitals that have high patient-to-nurse ratios. It also provides needed data showing a correlation between staffing and patient outcomes.

In-state approaches
PEF nurses are divided about the advisability of legislated staffing ratios. The PEF Statewide Nurses legislative subcommittee and the union's Legislative Department examined in detail the feasibility of adopting a California-type law in New York state and opted, instead, for an approach more similar to what New Hampshire is doing.

PEF is joining the SEIU New York State Council and the New York State Nurses Association in support of the Nursing Care Quality Protection Act.

Similar to New Hampshire's approach, this legislation requires hospitals to disclose staffing levels, based on acuity, for RNs, LPNs and unlicensed personnel. Facilities also have to report "nursing care quality indicators" such as rates of medication errors and infections, among other measures.

Time to lobby
PEF nurses will lobby for the Quality Protection Act on PEF Nurse Lobby Day March 14. This is the second year PEF nurses will visit the offices and meet with the staffs of state legislators, bringing with them their concerns about legislation that specifically impacts the nursing profession and urging support of the Quality Protection Act.

Not all nurses can join the lobbying effort in person, but they can make a difference on their own.

Individual nurses can support lobbying efforts by telephoning or writing to lawmakers urging their support for the Quality Protection Act.

If enough individual voices of nurses are heard, legislators can be persuaded that reporting quality indicators is the right thing to do - for nurses and for patients.

PEF Statewide Nurses Committee Legislative Agenda
· Quality Nursing Care (A2623/S3234) requires hospitals to disclose the number of licensed nurses providing care and the ratio of RNs to patients.

· Sharps Safety Act (S4936) requires the use of safer sharps and needles.

· Exempt Clause Repeal (A1183/S1058) repeals the exemption that allows unlicensed persons to provide nursing care for OMH/OMRDD.

· Whistleblower (A3089/S1453) protects health-care workers from retaliation if they blow the whistle on unsafe health-care practices.

Legislative support needed
PEF makes progress on Safe needles campaign

By MARY CAROLINE POWERS
PEF efforts to involve high-ranking state officials in the push for an end to needle-stick injuries are progressing.

Comptroller H. Carl McCall has agreed to meet with members of the Needlestick Injury Prevention
Task Force.

"I agree this is a serious issue that deserves the state's attention.... I think my staff could play a policy role," McCall wrote in a communiqué to PEF President Roger Benson.
At issue is the alarmingly high rate of needle-stick injuries - estimated by the Occupational Safety and Health Administration at 600,000 to 1 million per year for workers primarily in the health-care field. These accidents can expose them to HIV and the hepatitis B and hepatitis C viruses.

Purchasing peculiarity PEF is hoping McCall can smooth the way for increasing the number of state contracts with manufacturers of the safest needle-stick products on the market.

An oddity in the procedure for state-purchasing contracts stipulates that if a product is unsafe, that must first be proven before a facility can purchase a different, safer product.
"That's backwards," says Jonathan Rosen, director of PEF's Health and Safety Department and a member of the task force. "We're saying, to get on a state contract, a product should meet safety requirements first."

The state Office of Mental Health (OMH) went through an arduous process to get retractable safety needles on state contract. As a result, state and other public facilities can use that contract.
OMH facilities are now purchasing these devices, with input from rank-and-file nurses. One is the Mohawk Valley Psychiatric Center (MVPC), where a three-year test using retractable needles was conducted in an effort to reduce needle-stick injuries at
the facility.

In a report to OMH's Bureau of Health Services, MVPC's infection control nurse Carolyn Squillace noted that since April 1998 more than 5,000 retractable needles have been dispensed at the facility and no contaminated needle-stick injuries have been reported. In the years previous to the test, MVPC had eight such injuries in 1994, three in 1995 and five in 1996.

Other products that recently have undergone design improvements to reduce the risk of contamination include improved sharps containers, needleless intravenous equipment and closed blood-collection systems.

Achievable goals
The multi-union task force, which includes PEF representatives from the state Department of Correctional Services, Department of Health, OMH, Civil Service and SUNY, among others, has multiple goals:
· to get the issue before health-care managers and workers;
· to convince the state to allow its agencies to purchase the safest devices available; and
· to pass legislation that will mandate the use of safer needle devices in the state.
If New York passes the proposed legislation, it will be only the sixth state in the country to do so. The most recent was New Jersey where safe-needle legislation was signed into law January 5. It requires health-care facilities throughout New Jersey to employ safe-needle systems within the next 12 months. The law was passed after an intense lobbying effort by a coalition of concerned groups including one of PEF's international affiliates, the Service Employees International Union, which is aiding PEF in its effort to see similar legislation passed in New York. Six other states are considering safe-needle laws.

OSHA's safety mandate
Adding impetus to the effort is a new blood-borne-disease compliance directive to inspectors issued by the Occupational Safety and Health Administration that requires facilities with health-care operations to show they are using the safest equipment available. The state Department of Labor's Bureau of Public Employee Safety and Health (PESH) will adopt the OSHA directive.

"We're getting good cooperation at the top, but this needs to be implemented unit-by-unit, hospital-by-hospital," Rosen says. "And it's hard to get people to focus on safety issues in the current atmosphere of short staffing."

Safe needle legislation for NYS would:
· Require the use by health-care facilities of needles and sharps devices with integrated safety features as approved by the Food and Drug Administration;
· Establish a technical advisory committee, including workers, to oversee implementation of the legislative mandate;
· Impose civil penalties on employers who violate the provisions of the law.
The bill in the Senate (S.4936A) is in the Health Committee. The Assembly bill (A.7144B) is in Rules Committee.
Call your state legislators today at this toll-free number (877) 373-7920 and urge their support of the legislation.

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