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Staffing legislation at national level: ANA-supported staffing legislation introduced in the senate.

Appropriate staffing is the number one concern of nurses today and is critical to the delivery of quality patient care. Proper staffing levels allow nurses the time they need to make patient assessments, complete nursing tasks, respond to health care emergencies, and provide the level of care that their patients deserve. It also increases nurse satisfaction and reduces staff turnover, an important priority given today's nursing shortage and the projected shortfalls in the future. In the 108th Congress Sen. Daniel Inouye (D-HI) and Rep. Lois Capps (D-CA) worked with ANA to develop and introduce legislation to ensure adequate registered nurse (RN) staffing in health care facilities in response to the current nursing crisis. On January 4 of this year, Senator Inouye reintroduced this important legislation, the Registered Nurse Safe Staffing Act of 2007 (S. 73). The introduction of a companion bill in the House is expected soon.

S. 73 would mandate the development of staffing systems in hospitals aimed at ending the widespread practice of health care facilities stretching their nursing staff with unsafe patient loads, mandatory overtime, "floating" to specialty units without training and orientation, and other practices that undermine the delivery of safe, quality care. The bill also amends the conditions of participation for hospitals in the Medicare program and establishes a requirement for minimum staffing ratios. Rather than establishing a specific numeric ratio, the act requires the establishment of a staffing system that "ensures a number of registered nurses on each shift and in each unit of the hospital to provide for appropriate staffing levels for patient care.

"This is not a "one size fits all" approach to staffing. Instead, S. 73 ensures that nurse staffing can be tailored to the specific needs of each unit, based on factors including how sick the patient is, the experience of the nursing staff, available technology, and the support services available to the nurses. Most importantly, this approach treats nurses as professionals and empowers them at last to have a decision-making role in the care they provide.

Specifically the staffing system must:

* Be created with input from direct-care RNs or their designate representative;

* Be based on the number of patients and level of intensity of care to be provided, with consideration given to patient admissions, discharges and transfers on each shift;

* Reflect the level of preparation and experience of those providing care;

* Reflect staffing levels recommended by specialty nursing organizations; and

* Provide that an RN not be forced to work in a particular unit without having first established that he or she is able to provide professional care such a unit.

Another key provision of the bill is the requirement of public reporting of staffing information. Under the legislation, hospitals would be required to post daily the number of licensed and unlicensed staff providing direct patient care on each unit and each shift, while specifically noting the number of RNs.

Finally, the bill provides whistle-blower protections for RNs and others who may file a complaint regarding staffing. The bill establishes procedures for receiving and investigating complaints, and creates enforcement mechanisms, including civil monetary penalties, that can be imposed by the Secretary of Health and Human Services for each knowing violation.

The American Nurses Association will make passage of this staffing legislation a top priority. Please contact your Senators and to urge them to cosponsor S. 73 "The Registered Nurse Safe Staffing Act of 2007."

Editors comments:

This concepts seems right on target with the first goal appropriate safe staffing mix (Education, skills, experience of nurse in relationship to patient mix), then appropriate staffing ratios to achieve quality nursing care. The problem is how to attain and enforce. I am not sure how a minimum ratio will work since there are so many issues that must be considered: acuity of each patient, experience of each nurse, the demands of the entire unit, ancillary help (their experience).

Any ideas out there.? Wish there was an easy solution. That is what the legislators want to hear

Betty Razor

A further thought. The federal government already mandates hours of nursing time per day for nursing homes that accept Medicare/Medicaid. They will not raise those minimums because it will force the government to reimburse at a higher rate.

Nancy Menzel
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Title Annotation:ANA Updates/News; American Nurses Association
Author:Artz, Michelle
Publication:Nevada RNformation
Geographic Code:1USA
Date:Aug 1, 2007
Previous Article:ANA endorses Midwifery Care Access and Reimbursement Equity Act.
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