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| La. Bill Sets Ownership Rules for Rural ASCs
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The Louisiana State Senate recently approved a bill that requires new ASCs to enter into ownership agreements with rural hospitals if their development occurs within 25 miles of the hospital. According to SB570, the agreements would allow rural hospitals majority ownership of the ASCs.
A "rural hospital" is defined by Louisiana law as a hospital with fewer than 60 beds as of May 1, 2001, and located in parishes with a 2000 census population of less than 50,000 residents.
"Unchecked development of duplicative services will only cause further financial strain of the rural hospital, potentially causing the eroding of services or threatening their future financial viability and survival," says John Matessino, president and CEO of the Louisiana Hospital Association.
Advocates of ASCs disagree with the LHA. "It is astounding that one of the most important economic development initiatives for local communities — the development of an ambulatory surgery center — is being constrained in a state that is desperate for new investment," says Craig Jeffries, executive director of the AAASC.
Mr. Jeffries says Louisiana Gov. Kathleen Blanco is certain to sign SB570. He also notes that while the ownership bill is unique to Louisiana, legislative measures backed by hospital associations to restrict or limit physician ownership of facilities are active in about 15 states.
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| Hospital Study: Nurse Staffing Emergencies Still Await
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The majority of hospitals say the nursing shortage has become less severe over the past two years, thanks in part to long-term strategies such as nurse education and changing nurses' work environments, according to a study published online by Health Affairs. The survey, conducted last year, includes responses from 32 hospitals, 110 hospital executives and 78 other health experts.
While 10 of 24 hospitals surveyed that use temporary staffing say they have been able to scale back their use of per-diem and travel nurses, and four say they hope to do so soon, other short-term fixes "have increased costs and raised concerns about their potential impact on patient care."
These fixes include salary and benefits increases (which 78 percent of hospitals report doing), bonuses (44 percent) and flexible schedules (34 percent). The long-term strategies include training (69 percent), partnering with nursing schools or programs (34 percent), care delivery changes (59 percent) and physically changing the work environment (50 percent).
Despite these efforts and the reported recent easing of the nursing shortage, "a large degree of doubt exists among hospitals about their ability to meet future nursing needs," say the study authors. "[N]urse staffing will likely remain an important issue for health care providers in coming years[, as s]tudies forecast a growing gap between nurse supply and demand, with some estimates suggesting a deficit of more than one million nurses by 2012."
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| Assessing Pain in Nonverbal Patients
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Pain is a subjective experience. No objective tests exist to measure it. A new position paper issued by the American Society for Pain Management Nursing addresses pain assessment among nonverbal patients.
The statement and clinical recommendations cover three populations of nonverbal patients: elders with advanced dementia, infants and preverbal toddlers, and intubated and/or unconscious patients. The inability of these patients to self-report pain and discomfort - whether verbally, in writing or by such means as finger span or blinking eyes to answer yes-or-no questions - due to cognitive, developmental or physiologic issues is a major barrier to their being adequately assessed for pain and achieving adequate pain management interventions, the authors write in the paper, which was also published in Pain Management Nursing, vol. 7, no. 2. The paper offers strategies, tools and resources for appropriate pain assessment.
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| News and Notes
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Pain is a subjective experience. No objective tests exist to measure it. A new position paper issued by the American Society for Pain Management Nursing addresses pain assessment among nonverbal patients.
The statement and clinical recommendations cover three populations of nonverbal patients: elders with advanced dementia, infants and preverbal toddlers, and intubated and/or unconscious patients. The inability of these patients to self-report pain and discomfort - whether verbally, in writing or by such means as finger span or blinking eyes to answer yes-or-no questions - due to cognitive, developmental or physiologic issues is a major barrier to their being adequately assessed for pain and achieving adequate pain management interventions, the authors write in the paper, which was also published in Pain Management Nursing, vol. 7, no. 2. The paper offers strategies, tools and resources for appropriate pain assessment.
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