April 7, 2014

Senator Tom Berryhill

State Capitol, Room 3076
Sacramento, CA 95814

RE: SB 1269, Beall

Dear Senator Berryhill,

My name is Madison Krekow and I am a citizen of District 14 writing in regards to Californias healthcare
system. As a student graduating in May from California State University, Stanislaus with a degree in nursing, I
have concerns about the future of our acute healthcare systems.

Nurse-to -patient ratios are the number of patients that by law can be assigned to the care of one nurse.
Presently, nurse-to-patient ratios in hospitals ensure high quality patient care and safe practice standards for
both patients and the staff caring for them. Current law allows a breach in staffing ratios in two situations:
observation in the emergency department, and in outpatient surgical settings. What this means to the nurse is
that he/she may be assigned to care for an excessive and unsafe number of patients if they are under observation
before being admitted and if they have undergone surgery in an outpatient surgery setting. This leads to an
unsafe condition because both observational patients and surgical outpatients require the same amount of care
as general patients. In order to improve patient outcomes I urge you to vote yes on SB 1269.

SB 1269 would improve patient and nurse safety by requiring observational patients to be staffed at the same
nurse-to-patient ratios as inpatients. The bill would also require outpatient surgical services to be staffed at the
same levels as inpatient surgical settings. According to the most current research, appropriate nurse-to-patient
ratios improves patient outcomes by resulting in less hospital acquired infections, less hospital readmissions,
and fewer patient falls. Fewer hospital acquired infections, readmissions, and falls would save our hospitals
money by ensuring reimbursement from health insurance companies. Staff morale would also improve because
nurses would not feel overwhelmed by an unsafe number of patients. Increased morale within staff increases
employee retention which in turn saves our acute care hospitals money. Nurses work incredibly hard for their
patients to ensure a safe and secure environment and SB 1269 would promote the safety of all patients within
California. I thank you for all of your hard work on behalf of District 14 and the State of California.

Sincerely,




Madison Krekow
69 North Stewart Street
Sonora, CA 95370
mekrekow@gmail.com