Safe Staffing

Safe staffing can be a matter of life and death, and achieving the right staffing levels requires nurses and management working together. 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. 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 in the hospitals can yield a cost savings of nearly $3 billion—the result of more than four million avoided extra hospital stays for adverse patient events —and reduces costly hospital readmissions. Collaborative efforts among state hospital associations, nurse executives, and ANA-affiliated state nurses associations have resulted in balanced state-level 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).

Federally, ANA continues to work with lawmakers and the current administration on this critical issue, supporting a bipartisan for  safe nurse staffing levels..  Increasing the number of RNs per patient improves clinical and economic outcomes. 

ANA's approach takes into account:

  • 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; and
  • The intensity, complexity, and stability of patients.

This approach to staffing would:

  • Ensure RNs are not forced to work without orientation in units where they are not adequately trained or experienced;
  • Establish procedures for receiving and investigating complaints;
  • Allow the secretary of Health and Human Services to impose civil monetary penalties for each known violation;
  • Include whistleblower protections; and
  • Require public reporting of staffing information.

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