Nurses push for hospital accountability

Art Nadler

Wednesday, Aug. 26, 1998 | 10:50 a.m.

Several local nurses argued Tuesday for greater accountability from Southern Nevada hospitals at a hearing held by representatives of the state Bureau of Licensure and Certification.

Teresa Morrow, a nurse at University Medical Center, said the public has a right to know at any given moment the number of staff nurses on hand, patient status, infection-rate levels on various floors and any abnormalities such as incidents of patients falling and medication errors.

"We urge the bureau and Board of Health to begin collecting and publishing data on staffing and outcomes that are known to be linked to staffing and skill mix," said Beverly Phares, a registered nurse at Desert Springs Hospital. "We also urge the board to begin setting minimum staffing standards to protect the public from the economically driven race to the bottom (of expenditures)."

Several of the nurses alleged that hospitals, in their eagerness to obtain high-volume contracts from managed-care organizations, bid low and later cut nursing staffs to protect their profit margins. That's why, they contend, staffing levels of nurses fluctuate.

Ann Lynch, vice president of community services at Sunrise Hospital and Medical Center, said it would be impossible to maintain a set minimum nursing staff on any one hospital floor at any given time.

Nursing staffs, she said, are scheduled in accordance with the number of patients admitted on a day-to-day basis.

Sunrise Hospital maintains a variable staff pool (VSP), Lynch said, from which on-call nurses are brought in as the patient load grows.

With respect to disclosing infection rates, medication mistakes and injuries inside hospitals, Lynch said she would be concerned that the public would take the information out of context.

"I'm not opposed to disclosing this, as long as there is enough education," Lynch said. "Just to print statistics and numbers does more harm than good. To make a good judgment, you really have to know what you are reading."

Hospitals are protected, by law, from disclosing sensitive information about what are termed as sentinel events. These are events that result in an unanticipated death, major permanent loss of function, infant abduction, discharge of an infant to a wrong family, rape of patient, etc.

Hospitals are given peer-review privileges in these matters, in which internal investigators interview doctors, nurses and medical personnel involved in the event.

Hospital administrators argue that these people wouldn't come forward if they knew the investigation would be made public.

Laws in every state give hospitals authority to police themselves and correct procedures so that similar sentinel events won't occur again.

Diane Allen, health-facilities surveyor with the Bureau of Licensure and Certification, said she will present Tuesday's recommendations to the state agency for consideration.

The proposed regulation changes will be discussed at a state Board of Health meeting at 9 a.m. Oct. 9 at the Grant Sawyer Building, Room 4401, 555 E. Washington Ave.