Twenty-two years ago, the federal government started keeping a list of nurses, nurse aides, pharmacists and pharmacy aides who've been disciplined by state licensing boards. It's called the Healthcare Integrity and Protection Data Bank.
But hospitals and nursing homes aren't allowed to see the database.
By law, it was supposed to be open to hospitals and nursing homes when they hire staff and want to run a background check. But the Department of Health and Human Services never completed the regulation implementing the law. Turns out, slow-moving bureaucracy is the main culprit.
"There's really no reason for it at all," says Dr. Sidney Wolfe, who runs the consumer advocacy organization Public Citizen's Health Research Group.
Wolfe notes that there are more than 102,000 nurses, nurse aides, pharmacists and pharmacy assistants who've been disciplined and included in the registry, but that hospitals and nursing homes can't check the data bank. There's also a separate, national data bank of doctors who've been disciplined, he adds, and that list can be checked by hospitals.
"There are probably more records of disciplined nurses and nurses aides than there are of disciplined doctors, except the doctors stuff is in the data bank, accessible to hospitals. The nurses, nurses aides and pharmacists are secret right now."
Wolfe recently wrote a letter to Kathleen Sebelius, the Secretary of Health and Human Services, asking for an end to the secrecy around the registry of disciplined health care workers.
Putting Patients' Safety First
States keep their own discipline records that hospitals and some nursing homes can access. But health care workers move from state to state. So Wolfe says there's a need for access to a centralized, federal data bank.
"Until the government makes these data available, patients are going to be injured in hospitals by nurses, nurse's aides who shouldn't be on the staff of the hospital. The only reason they're on the staff is: when the hospital hired them they didn't know what their past records was," Wolfe says.
Nurses want the registry to be open, too.
"We believe that this registry is a good registry," says Rebecca Patton, president of the American Nurses Association. "And we believe that impaired, unsafe nurses should be addressed and the public should be protected from those situations."
Hospitals and nursing homes could use a federal data bank to run accurate background checks, in addition to counting on state discipline records.
"This data base would likely not be something we rely on as the only source of information," says Nancy Foster, vice president for quality and patient safety policy for the American Hospital Association.
"But it would be one source of information we might check to make sure we don't miss a vital piece of information about a person we're going to hire to care for the patients we serve."
Regulation Still In Limbo
In 2006, the Department of Health and Human Services started the process of writing a regulation. It got public comment, and reactions from seven or eight government agencies.
A year ago, during the Bush administration, the department finished the regulation. But then the White House froze it — and said it should be up to the new president to decide what to do next.
So it's all under review again. A spokeswoman for the Department of Health and Human Services says things are on track. And that maybe by early next year, the department will open the registry of disciplined nurses, aides and pharmacists.