Safe Staffing

Adding Registered Nurses (RNs) to unit staffing has eliminated nearly one-fifth of all hospital deaths and reduced the relative risk of adverse patient events, such as infection and bleeding. (Kane, 2007)

Reducing medical errors is particularly important because the Centers for Medicare & Medicaid Services (CMS) has started denying payment for preventable hospital-acquired injuries or illnesses, and other private insurers are expected to follow suit.

Increasing the number of RNs can yield a cost savings of nearly $3 billion—the result of more than four million avoided extra hospital stays for adverse patient events (Needleman, 2011)—and reduces costly hospital readmissions.

Collaborative efforts among state hospital associations, nurse executives, and ANA-affiliated state nurses associations have resulted in balanced staffing legislation that benefits patients, nurses, and hospitals. Seven states have already enacted safe staffing legislation using the Registered Nurses Safe Staffing Act’s committee approach: Oregon (2002), Texas (2009), Illinois (2007), Connecticut (2008), Ohio (2008), Washington (2008), and Nevada (2009).

The Registered Nurse Safe Staffing Act protects patients
This bipartisan legislation requires Medicare-participating hospitals to establish a committee, composed of at least 55% direct care nurses, to create nurse staffing plans that are specific to each unit. This committee approach to creating nurse staffing plans recognizes that direct care nurses, working closely with managers, are best equipped to determine the staffing levels for their patients. Without appropriate RN staffing, patients risk longer hospital stays, increased infections, avoidable medication errors, falls, injuries, and even death.

The Registered Nurse Safe Staffing Act protects nurses. Hospitals are feeling pressure to reduce labor costs by eliminating or understaffing registered nurse positions. This leads to lower nurse retention rates and increased readmissions. Increasing the number of RNs per patient improves clinical and economic outcomes.

The Registered Nurse Safe Staffing Act considers:

  • RN educational preparation, professional certification, and level of clinical experience.
  • The number and capacity of available health care personnel, geography of a unit, and available technology.
  • The intensity, complexity, and stability of patients.

The Registered Nurse Safe Staffing Act also:

  • Ensures RNs are not forced to work without orientation in units where they are not trained or experienced.
  • Establishes procedures for receiving and investigating complaints.
  • Allows the secretary of Health and Human Services to impose civil monetary penalties for each known violation.
  • Includes whistleblower protections.
  • Requires public reporting of staffing information.

This legislation presents a balanced approach that promotes the development and implementation of valid, reliable, unit-by-unit nurse staffing plans to ensure patient safety.