Noting the decline in professional employees on staff at many health care institutions and the substitution of cheaper, unlicensed personnel, ANA established the "Principes for Nurse Staffing."  These Principles provide recommendations on appropriate staffing to reverse this trend and for reclaiming a safe environment for nurses and patients.  1998 saw the first legislation passed by KY and VA to set appropriate staffing methodology.  In 1999, CA was able to pass significant legislation to require nurse-to- patient ratios in acute care hospitals.  NH approved data collection on the rates of RNs per bed.  NM agreed to study the education and training mix necessary for personnel to meet state health care demands and RI adopted a House study on patient care and nurse staffing in acute care hospitals. Efforts continue in this year's legislative sessions.  ANA is monitoring 34 bills in 16 states.  The HI Senate adopted a resolution that urges HNA and the Health Care Association of HI to find solutions to patient safety and nurse shortage issues.  Legislation that is pending can be generally classified into 2 categories-those requiring sufficient staffing to ensure safe patient care and bills setting specific nurse-to- patient ratios.  CA, MA, NJ, NY, OH, RI, and TN are still considering sufficient staffing legislation.  The majority of these bills also require public reporting of data and the development of staffing data on the skills and  credentials of nurses providing care and patient acuity.  Ratio-setting legislation is pending in IL, NJ, PA and RI.  Similar legislation in AZ, HI and WV did not pass this year.  CA has legislation pending that would extend the deadline for health care facilities to adopt nurse-to-patient ratios and one that would waive the ratio requirements for rural acute care hospitals. Some states have begun to also recognize the nationwide trend toward nurse shortages.  CT, HI and MD all attempted to address this concern.  The CT bill did not pass but HI's previously noted resolution and MD's bill were adopted.  MD's law creates a Statewide Commission on Crisis in Nursing including the MD SNA and BON as members to determine the extent and implication of the growing nurse shortage.

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2000 State Legislative Trends main page

Sufficient Staffing/Nurse Ratios information