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Issue Background

Safe Staffing

Appropriate staffing is essential to the delivery of safe and effective patient care, and it helps to ensure efficient throughput processes in the emergency department. Evidence supports that appropriate staffing leads to better patient outcomes.

Efforts are increasing across the country to enact legislation mandating specific nurse-to-patient ratios for all units within hospitals, including emergency departments. However, mandating one-size-fits-all nurse-to-patient ratios is limited in scope and does not consider the variables that affect the consumption of nursing resources. They don’t take into account differing factors at hospitals across a state, such as typical patient acuity and the level of training and experience of the registered nurses at each hospital.

ENA believes every health care facility should work with its nursing staff to implement a system that ensures appropriate nurse staffing levels. That is why we support legislation requiring all hospitals to form staffing committees comprised of 55% direct care nurses. The committees would be tasked with developing unit-specific nurse staffing plans to ensure high-quality care focused on the medical needs of the patient. Factors the committee would consider include input from direct care RNs, the number of patients a hospital has, and the level of education, training, and experience of the registered nurses providing the care.

This type of mandatory committee staffing plan has been shown to improve patient safety and nurse satisfaction levels, while reducing costs, saving lives, and reducing the incidence of medication errors, dangerous infections, and patient falls within hospitals nationwide. Emergency nurses must stand up and support these plans, while opposing efforts to mandate one-size-fits-all nurse-to-patient ratios.