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 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) has been reintroduced for the current 110th Congress. Senator Inouye has again sponsored the Senate bill, and we are pleased to report that Rep. Ginny Brown-Waite (R-FL) joined Rep. Lois Capps (D-CA) this session as a lead sponsor of the House bill when it was introduced on Nov. 9th. H.R. 4138/S. 73, 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.
S. 73/H.R. 4138 would:
- Require 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.
- Ensure 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.
- Require 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.
- Hold hospitals accountable and establishing procedures for receiving and investigating complaints.
- Allow the Secretary of Health and Human Services to impose civil monetary penalties for each knowing violation.
- Provide whistle-blower protections for RNs and others who may file a complaint regarding staffing
Resources
- Registered Nurse Safe Staffing Act of 2007 (S.73/H.R. 4138)
- The American Nurses Association, the New York State Nurses Association, and the Washington State Nurses Association filed a lawsuit in June 2006 against the Department of Health and Human Services (HHS). The groups claim HHS allows hospitals that fail to meet federal nurse staffing requirements to participate in Medicare, thereby endangering patients. The groups also seek to prevent HHS from allowing the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) to use its own, minimal standards for nurse staffing in its accreditation of hospitals.
- Acute Care Staffing [pdf]
- Nurse Staffing Reporting [pdf]
- ANA Applauds Introduction of Registered Nurse Safe Staffing Act [pdf]
- Write Your Member of Congress