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Registered Nurse Safe Staffing Bill Introduced In Congress


The American Nurses Association (ANA) applauds the introduction of federal legislation that empowers registered nurses (RNs) to drive staffing decisions in hospitals and, as a result, protect patients and improve the quality of care.

On the heels of the introduction of the Registered Nurse Safe Staffing Act of 2010 (S. 3491/H.R. 5527), hundreds of registered nurses from across the country flocked to Capitol Hill last month to meet with their congressional representatives, emphasizing that insufficient nurse staffing can be a life-or-death issue for patients and that federal legislation is needed to ensure that hospitals don’t limit resources in a way that harms patient outcomes.

The RN Safe Staffing Act, crafted with input from ANA, has sponsors from both political parties – Sen. Daniel Inouye (D-HI) and Reps. Steven LaTourette (R-OH) and Lois Capps (D-CA), a nurse.

“We know that nurses across the country are deeply concerned about unsafe staffing because it puts patients at risk, as well as puts nurses’ careers on the line,” said ANA President Karen Daley, PhD, MPH, RN, FAAN. “Nurses observe all the time how insufficient nurse staffing diminishes the quality of care for patients. We won’t stop advocating on this issue until federal legislation is enacted to increase protections for patients and ensure fair working conditions for nurses.”

Research has shown that higher staffing levels by experienced RNs are linked to lower rates of patient falls, infections, medication errors, and even death. And when unanticipated events happen in a hospital resulting in patient death, injury or permanent loss of function, inadequate nurse staffing often is cited as a contributing factor.

The bill would require hospitals to establish committees that would create unit-by-unit nurse staffing plans based on multiple factors, such as the number of patients on the unit, severity of the patients’ conditions, experience and skill level of the RNs, availability of support staff and technological resources.

ANA backed a similar staffing bill in the last Congress. This version includes new requirements that a hospital’s staffing committee be comprised of at least 55 percent direct care nurses or their representatives, and that the staffing plans must establish adjustable minimum numbers of RNs per unit.

ANA has a long track record of advocating for safe staffing conditions for the nation’s registered nurses, through development of ANA’s Principles for Nurse Staffing in 1999, work with legislators and implementation of a national nursing quality database program that correlates staffing to patient outcomes. In 2007, the association launched its “Safe Staffing Saves Lives” grass-roots campaign, calling on nurses to become advocates. Nearly 1,000 RNs have sent their personal stories to ANA, describing how insufficient staffing on their units has put their patients in jeopardy, overwhelmed them with unmanageable patient loads, and, in some cases, driven them from their jobs.

The safe staffing bill would require hospitals that participate in Medicare to publicly report nurse staffing plans for each unit. It would place limits on the practice of “floating” nurses by ensuring that RNs are not forced to work on units if they lack the education and experience in that specialty. It also would hold hospitals accountable for safe nurse staffing by requiring the development of procedures for receiving and investigating complaints; allowing imposition of civil monetary penalties for knowing violations; and providing whistle-blower protections for those who file a complaint about staffing.

To date, seven states have passed nurse safe staffing legislation that closely resembles ANA’s national approach to ensure safe staffing. Those states are Connecticut, Illinois, Nevada, Ohio, Oregon, Texas and Washington.

American Nurses Association

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