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Advocating for Safe Staffing

Safe staffing is one of ANA’s core federal policy priorities. We work closely with our constituent and state nurses associations to monitor and advocate for state-level policies, which generally follow three approaches:

  1. Staffing committees. Nurse-led groups that create unit-level staffing plans based on a patient population’s acuity and needs, matched with staff’s skills and experience.
  2. Mandated nurse to patient ratios or standards, in legislation or regulation.
  3. Mandated disclosure of staffing levels, to the public and/or regulatory bodies.

ANA supports a legislative model incorporating nurse-driven staffing committees because this approach encourages flexible staffing levels. At least 55 % of staffing committee members should be direct care nurses.

As of March 2022, 16 states currently address nurse staffing in hospitals through either laws or regulations:

  • Hospital-based: Eight states with committees comprised of at least 50% direct care nurses: CT, IL, NV, NY, OH, OR, TX, WA. One state where a Chief Nursing Officer develops a core staffing plan: MN.
  • Nurse to patient ratios/standards. Two states: CA, MA
  • Disclosure and/or reporting requirements. Five states: IL, NJ, NY, RI, VT

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