ANA's Support for Safe Staffing
For more than a decade, studies have pointed to a number of positive outcomes for patients and nurses when safe staffing plans are established in hospitals and other health care settings. Research findings support the impact of adequate nurse staffing on reducing patient complications and mortality, promoting safe work environments, and improving job satisfaction and retention among nurses. Safe staffing is at the core of the American Nurses Association (ANA)'s efforts to promote patient safety and quality health care.
Three different approaches have been proposed to ensuring safe staffing:
- Nurse Staffing Plans: requires hospitals to develop and staff units according to plans based on patient, nurse and unit-level needs, with input from direct-care nurses.
- Nurse-to-Patient Ratios: sets minimum fixed ratios through legislation or regulation.
- Combination of Nurse Staffing Plans and Nurse-to-Patient Ratios.
The ANA supports legislation consistent with ANA's Principles on Safe Staffing, which recommends that staffing plans be established according to patient acuity, nursing experiences and skill mix, and unit-level circumstances. Instead of a “one-size-fits-all” model, this plan-based approach enables direct-care nurses to actively participate in developing safe staffing systems within their work settings. An accompanying document – Utilization Guide for the ANA Principles for Nurse Staffing – provides details on assessing the adequacy of nurse staffing on patient care units.
The ANA helped to introduce and is a staunch supporter of the Registered Nurse Safe Staffing Act of 2007 (S.73/H.R.4138): federal legislation reintroduced in the 110th Congress by Senator Daniel Inouye (D-HI), Representative Lois Capps (D-CA) and Representative Ginny Brown-Waite (R-FL). This legislation, which is consistent with the ANA's Principles for Nurse Staffing , would hold hospitals accountable for establishing valid, reliable, unit-level nurse staffing plans. These plans would be developed in consultation with direct-care RNs and be based on each unit's needs and characteristics. Hospitals would also be required to post daily public reports of staffing levels and provide whistleblower protections for RNs and others who might file a complaint about staffing.
The ANA's Safe Staffing Website is the hallmark of its campaign to help nurses learn about safe staffing issues and become advocates for safe staffing legislation. Key features of this website include research findings, legislative updates, and online tools for nurses to share their stories and communicate with elected officials about the impact of safe staffing on patient safety and quality health care.