Identifying and maintaining the appropriate number and mix of nursing staff is critical to the delivery of quality patient care. Numerous studies reveal an association between higher levels of experienced RN staffing and lower rates of adverse patient outcomes.
When health care employers fail to recognize the association between RN staffing and patient outcomes, laws, and regulations become necessary.
State staffing laws tend to fall into one of three general approaches:
- The first is to require hospitals to have nurse-driven staffing committees that create staffing plans that are reflective of the needs of the patient population and match the skills and experience of the staff.
- The second approach is for legislators to mandate specific nurse to patient ratios in legislation or regulation.
- A third approach is requiring facilities to disclose staffing levels to the public and/or to a regulatory body.
ANA supports a legislative model in which nurses are empowered to create staffing plans specific to each unit. This approach aids in establishing staffing levels that are flexible and account for changes including:
- intensity of patient’s needs,
- the number of admissions, discharges, and transfers during a shift,
- level of experience of nursing staff,
- layout of the unit,
- and availability of resources (e.g., ancillary staff, technology).
Establishing minimum, upwardly adjustable staffing levels in statute will also help the committee in achieving safe and appropriate staffing plans.