State Sen. Daylin Leach, D-17, of Upper Merion, is crafting legislation that would establish minimum registered nurse-to-patient ratios in Pennsylvania medical facilities.

“Various reports in recent years have found that insufficient staffing has a direct correlation to lives lost in patient care,” said Leach in a release. “(The Pennsylvania Hospital Patient Protection Act of 2009) will set a standard that medical facilities must comply with, and will ensure that we as a state are doing our best to provide safe care to our patients — and a safe working environment to our health workers.”

The law would also provide “whistle-blower” protections to health-care workers that speak out about unsafe patient-care conditions. State Rep. Tim Solobay, D-Washington County, introduced similar legislation in the state House in January.

In the release, Leach cited a 2005 report from the American Journal of Public Health that found keeping the patient-to-nurse ratio at 4 to 1 could save up to 72,000 lives annually and reduce costs.

“This law will guarantee the safe care of patients while creating conditions in our hospitals that will help retain and recruit RNs,” said Leach. “Ratios reduce costly medical errors, hospital infections and the significant expense of replacing the increasing numbers of RNs who leave the bedside due to unsafe staffing conditions.”

Pennsylvania Association of School Nurses and Practitioners (PASNAP) Executive Director Bill Cruice, who helped Leach draft the legislation, said it was based on a similar bill implemented in California in 2004.

“Now that the (California) law has been in place five or six years fully implemented, the evidence is irrefutable that it just makes sense for patient care, for nurse recruitment and retention, and, frankly, it just makes sense for hospital bottom lines,” said Cruice. “The California experiment demonstrated that with minimum nurse-to-patient standards, nurses will remain in the profession, nurses that have left the profession will return, and I don’t know if this is a good thing or a bad thing, but nurses from neighboring states … actually moved to California because they knew the conditions for nurses were going to be better (there).”

That could be the only real drawback to the bill, said Cruice — that it could negatively impact nursing levels in surrounding states. But he added that there might soon be a federal law to address minimum-nursing ratios, which would eliminate that problem.

Another potential downside is the redirecting of resources necessary to meet the mandates of the bill, though Cruice wasn’t convinced that would really make a difference in overall service, especially in the wealthier local hospitals.

Cruice noted most hospitals do meet minimum-staffing standards in many units most of the time, but in non-intensive care units, nurses can become overburdened because of a perception that patients in those units are not high-risk.

“That is a myth,” said Cruice. “These days, anybody who is in a hospital bed is extremely ill. Insurance companies won’t let you get in if you are not extremely ill and they kick you out the moment you are not extremely ill.”

But providing adequate nurse staffing levels at all levels would help prevent many kinds of infections and medical errors that occur in those understaffed units, said Cruice.

That’s because nurses act as “early-warning systems” for hospitals. And if they can help reduce mistakes or infections, he said, that will not only help patients, but improve revenues — especially in light of recent Medicare changes that do away with reimbursements to hospitals for the cost of care resulting from medical error or hospital-caused infection.

“So not only will the legislation be an improvement for nurses, increasing their professional satisfaction because they have the time to spend with their patients, the data demonstrates that the outcomes will be a boon for patient care and also to the hospital’s bottom line,” he said.