Federal Legislation: Registered Nurse Safe Staffing Act
Resources
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.
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), then refined for the 2009-2010 session (S. 3491/ H.R. 5527). Sponsors of the current bill are Sen. Inouye and Reps. Lois Capps (D-CA) and Steven LaTourette (R-OH).
The legislation would hold Medicare-participating hospitals accountable for the development of unit-by-unit nurse staffing plans. These plans would be developed by committees comprised of at least 55% direct care nurses, and would be based on each unit’s unique characteristics and needs.
The RN Safe Staffing Act also would:
- Establish adjustable minimum numbers of RNs for each unit.
- Ensure that staffing plans:
- are based upon patient numbers and the severity of the patients' health needs (acuity).
- take into account the level of education, training and experience of the RNs.
- take into account the availability of support staff.
- reflect staffing levels recommended by specialty nursing organizations.
- consider the physical layout of the unit and available technology.
- do not require RNs to work in units where they are not trained or experienced.
The bill also includes compliance provisions that would:
- 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.
- require the collection and submission of data that could be used to establish a link between nurse staffing and patient acuity.
- 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
- Full text of RN Safe Staffing Act of 2010 [PDF]
- Acute Care Staffing -- ANA Position [pdf]
- Nurse Staffing Reporting -- ANA Position [pdf]
- ANA Applauds Introduction of Registered Nurse Safe Staffing Act - 2007 [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.