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The report by the Institute of Medicine that up to 98,000 people die each year because of medical errors highlights the failures of a health-care system that is driven by market forces rather than quality of care.

As the front-line providers of health care, registered professional nurses have long warned about policies and practices that endanger patients' lives. This report illustrates why these warnings should be taken seriously.

There are steps that can be taken to help make hospitals safer for patients:

Disclose quality indicators. The New York State Nurses Association, of which I am president, and other labor and consumer groups have introduced legislation that would require facilities to disclose "quality indicators" such as the incidence of medication errors, in-hospital infections and patient falls.

Provide adequate staffing. With the trend toward shorter patient hospital stays, patients in the hospital are sicker than ever, yet the ratio of patients to nurses has increased. A survey of registered nurses conducted by NYSNA found that nearly half did not have the time to provide the care their patients needed.

Unbearable workloads, mandatory overtime and lack of staff all create an environment where mistakes and accidents are more likely to occur. Nurses have been forced to go on strike because their hospitals refused even to create committees to establish safe staffing ratios.

Stop retaliation against whistle-blowers. Experts agree that more information about quality of care needs to be available to the public and regulatory agencies. Yet all too often, nurses who raise concerns about patient safety are threatened with retaliation or dismissal.

For three years, New York nurses have been pushing for a state law that will protect workers who "blow the whistle" about unsafe patient-care practices. Now is the time for the Legislature and the governor to include such a provision in the new Health Care Reform Act.

The quality of health care in our nation falls far short of what it should be. We need to make patient safety a priority at both national and state levels -- and nurses are ready to lead the way.


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