Federal Legislation: Registered Nurse Safe Staffing Act
Many factors, including acuity of patients, level of experience of nursing staff, layout of the unit, level of ancillary support—are key to establishing the “right” nurse-patient ratio for any one unit. This is why ANA originally worked with Sen. Daniel Inouye (D-HI) and Rep. Lois Capps (D-CA) during the 108th Session of Congress (2003-2004) to develop and introduce the Registered Nurse Safe Staffing Act--legislation that would hold hospitals accountable for the development and implementation of valid, reliable nurse staffing plans based on each unit’s unique characteristics and needs.
The Registered Nurse Safe Staffing Act (S. 73 / H.R. 4138) was reintroduced for the 110th Congress (2007-2008). Senator Inouye again sponsored the Senate bill. Rep. Ginny Brown-Waite (R-FL) joined Rep. Lois Capps (D-CA) as a lead sponsor of the House bill. The legislation, which is being prepared for introduction in the 111th Congress (2009-2010), would hold hospitals accountable for the development of valid, reliable unit-by-unit nurse staffing plans. These plans would be developed in coordination with direct care registered nurses (RNs) and based on each unit’s unique characteristics and needs.
ANA's proposal for the 111th Congress (2009-2010) will adhere to the principles included in S. 73/H.R. 4138 (110th Congress), which would have:
- Required the establishment, in coordination with direct care registered nurses, of a staffing system that ensures a number of registered nurses on each shift and in each unit of the hospital to ensure appropriate staffing levels for patient care.
- Ensured that the staffing system: considers the architecture and geography of the environment and available technology; reflects the level of preparedness and experience of those providing care; reflects staffing levels recommended by specialty nursing organizations; accounts for ancillary staff support; provides that an RN not be assigned in a particular unit without first having established the ability to provide professional care in such a unit; is based on methods that assure validity and reliability.
- Required public reporting of staffing information. Hospitals must post daily for each shift the number of licensed and unlicensed staff providing direct patient care, specifically noting the number of RNs.
- Held hospitals accountable and establishing procedures for receiving and investigating complaints.
- Allowed the Secretary of Health and Human Services to impose civil monetary penalties for each knowing violation.
- Provided whistle-blower protections for RNs and others who may file a complaint regarding staffing
Resources
- Registered Nurse Safe Staffing Act
- The Registered Nurse Safe Staffing Act would hold hospitals accountable for the development of valid, reliable unit-by-unit nurse staffing plans. These plans would be developed in coordination with direct care registered nurses (RNs) and based on each unit’s unique characteristics and needs.
- Acute Care Staffing [pdf]
- Nurse Staffing Reporting [pdf]
- ANA Applauds Introduction of Registered Nurse Safe Staffing Act [pdf]
- The American Nurses Association (ANA) commends the introduction of bipartisan federal legislation aimed at implementing staffing systems that ensure appropriate registered nurse staffing levels in health care facilities.