ANA Leading Patient Safety
ANA supports state and federal regulations and legislation that allow for flexible but adequate nurse staffing plans.
Current Gaps in Federal Legislation
Federal regulation (42CFR 482.23(b)) requires hospitals certified to participate in Medicare to "have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed." This nebulous language and the continued failure of Congress to enact The Registered Nurse Staffing Act has resulted in states taking action to ensure there is optimal nurse staffing appropriate to patients' needs. ANA supports state and federal regulations and legislation that allow for flexible nurse staffing plans.
Transparent Public Reporting
ANA's advocacy of transparency has been successful in key steps to achieve public reporting of staffing and skill mix data through work with the National Quality Forum (NQF).
Specifically, reporting of measures publicly will act as an effective quality policy lever to reduce variances in hospital nurse staffing and skill mix that are associated with patient death and harm.
In 2014 and 2015, ANA led to its staffing and skill mix measures being advanced for review for public reporting by the Measures Application Partnership. In 2016, ANA's staffing and skill mix measures were endorsed by the NQF at the hospital level of reporting. This endorsement was essential to pave the way for national quality safety data about hospitals to be available for consumers, purchasers and all stakeholders when making health care decisions. ANA continues to work with CMS to advance these measures in CMS's hospital public reporting program, Inpatient Quality Reporting, via CMS regulations.
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