The American Nurses Association (ANA) commends Senator Jeff Merkley (D-OR) and Representatives Lois Capps (D-CA) and David Joyce (R-OH) for introducing the Registered Nurse Safe Staffing Act. This bill would require Medicare-participating hospitals to establish registered nurse (RN) staffing plans using a committee, comprised of a majority of direct care nurses, to ensure patient safety, reduce re-admissions and improve nurse retention.
Endorsed by ANA, the Registered Nurse Safe Staffing Act (H.R. 2083/ S. 1132) presents a balanced approach to ensure adequate RN staffing by recognizing that direct care nurses, working closely with managers, are best equipped to determine the staffing level for their patients. Without the necessary nurse coverage, patients risk longer hospital stays, increased infections, avoidable medication errors, falls, injuries and even death.
The bill’s sponsors chair Congress’ Nursing Caucus, Merkley in the Senate and Capps and Joyce jointly in the House. The Nursing Caucus educates lawmakers on issues significant to the profession and patients, and the impact of nurses on the health care system.
“Optimal nurse staffing could mean the difference between a patient surviving or dying,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. “Research tells us it’s that crucial. If you or your loved one were in the hospital, you’d want to be certain that the hospital was continually setting, evaluating and adjusting its nursing coverage to meet your changing needs and the conditions of all patients. That is what this legislation seeks to ensure.”
Research has shown that higher staffing levels by experienced RNs are linked to lower rates of patient falls, infections, medication errors and even death. One study showed the likelihood of overall patient mortality (in-hospital death) and mortality following a complication increases by 7 percent for each additional patient added to the average RN workload.
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.
In setting staffing plans, the Registered Nurse Safe Staffing Act considers:
- RN educational preparation, professional certification and level of clinical experience.
- The number and capacity of available health care personnel, geography of a unit and available technology.
- Intensity, complexity and stability of patients.
It also includes these patient protection, reporting, investigation and enforcement provisions:
- RNs would not be forced to work in units where they are not trained or experienced without orientation.
- Procedures for receiving and investigating complaints.
- Potential for civil monetary penalties imposed by the Secretary of Health and Human Services for each known violation.
- Whistleblower protections.
- Public reporting of staffing information.
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ANA is the only full-service professional organization representing the interests of the nation’s 3.1 million registered nurses through its constituent and state nurses associations and its organizational affiliates. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.