ANA Lauds Registered Nurse Safe Staffing Bill Introduced In Senate
The American Nurses Association (ANA) collectively applauds the
introduction of federal legislation in the U.S. Senate that empowers registered
nurses (RNs) to drive staffing decisions in hospitals, protect patients and
improve the quality of care.
The Registered Nurse Safe Staffing Act of 2014 (S. 2353), crafted with
input from ANA, is sponsored by Sen. Jeff Merkley (D-OR). ANA supports a companion staffing
bill introduced in the House in May 2013, the
Registered Nurse Safe Staffing Act of 2013 (H.R. 1821).
“It is encouraging that members of both chambers of Congress understand
the connection between nurse staffing and patient safety. There is no room for
debate: when there are appropriate nurse staffing levels, lives are saved and
patient outcomes improve,” says ANA President Karen A. Daley, PhD, RN, FAAN.
“With federal legislation we can vastly advance the quality of patient care and
improve working conditions for nurses.”
According to ANA, 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.
“As the husband of a nurse, I know firsthand the many challenges nurses
face and how critical their care is to patients,” says Sen. Merkley. “Safe
staffing that enhances patient care, reduces medical errors and bolsters nurse
retention all at the same time would be a tremendous improvement to health care
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
“As a nurse, and someone who’s been involved in both patient care
and policy discussions about staffing for decades, I’m so pleased to see Sen.
Merkley standing up for patients in hospitals across the country,” said Susan
King, MS, RN, CEN, FAAN, executive director of the Oregon Nurses Association, a
constituent member of ANA.
“We know that nurse staffing levels impact patient outcomes and nurse
retention, and—as the people providing care to patients—nurses bring an
intimate understanding of patient needs to the discussion about how to most
appropriately staff a facility. This is critical legislation for every
patient in a hospital and for the nurses who care for them.”
The safe staffing bill also 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.
Additionally, ANA has advocated for optimal nurse staffing through the
development and updating of ANA’s Principles for Nurse Staffing, and development
of a national
nursing quality database program that correlates staffing to patient
To date, seven states have passed nurse safe staffing legislation that
closely resembles ANA’s recommended approach to ensure safe staffing,
utilizing a hospital-wide staffing committee in which direct care nurses have a
voice in creating the appropriate staffing levels. Those states are
Connecticut, Illinois, Nevada, Ohio, Oregon, Texas, and Washington.
For more information on ANA’s safe staffing legislative efforts, please