2008 Resolution - Number 2-08

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SUBJECT: Reaffirmation and Expansion of UAN Safe Staffing Campaign

Introduced by: Minnesota Commission on Economic and General Welfare

Action: Unanimously Passed 3/9/08

WHEREAS, time spent with nurses is associated with the quality of care hospital patients receive as measured by adverse patient outcomes; and

WHEREAS, workload and work schedules can impede quality care delivery; and

WHEREAS, increases in the amount of work expected of nurses contributes to nurse fatigue, correlating high workloads and stressful work environments with reduced patient outcomes and satisfaction; and

WHEREAS, extended shifts and mandatory overtime harm quality of patient care. Research through the Institute of Medicine found that longer work hours and fatigue reduce nurse job functioning and an increase in errors with longer work hours and performance of overtime, regardless of the length of the original shift (Rogers, Hwang, Scott, Aiken, and Dinge 2004); and

WHEREAS, the use of temporary workers, who are far less familiar with facility procedures and staffing than regular employees, is associated with higher indicators of poor quality of care; i.e., medical error and infections (Solving the Nursing Shortage); and

WHEREAS, higher Registered Nurse staffing levels are cost effective for hospitals (Kovner, Jones, Zahn, Gergen, and Basu 2002, McCue, Mark, and Harless 2003); and

WHEREAS, quality public health care, cost, and patient outcomes is inherent to health care and nursing; and

WHEREAS, Registered Nurses, as the most trusted profession, have the obligation to advocate for the public in assurance of quality, safe patient care; and

WHEREAS, establishing safe staffing standards for direct care Registered Nurses is a critical component of assuring that there is adequate hospital staffing at all levels to improve the delivery of quality care and protect patient safety (HR 2123: Nurse Staffing Standards for Patient Safety and Quality Care Act); and

WHEREAS, evidence-based studies have shown that the basic principles of staffing in the acute care setting should be based on the complexity of patients’ care needs aligned with available nursing skills to promote quality patient care consistent with professional nursing standards; and

WHEREAS, acuity model means an assessment tool selected and implemented by a hospital group that assesses the complexity of patient care needs requiring professional nursing care and aligns patient care needs and nursing skills consistent with professional nursing standards; and

WHEREAS, multiple states have introduced legislation to address the health care crisis related to Registered Nurse staffing issues; and

WHEREAS, establishing safe staffing standards for direct care Registered Nurses is a critical component of assuring that there is adequate hospital staffing at all levels to improve the delivery of quality care while protecting and maintaining patient safety;

THEREFORE BE IT RESOLVED, that the United American Nurses reaffirm and expand its Safe Staffing Campaign through organizing and outreach to nurses and nursing unions, seek enactment of state and federal safe staffing legislation, and support collective bargaining, research, and educational initiatives related to safe staffing including, but not limited to, the following campaign organizing activities:

• Mobilize Registered Nurses to actively support Safe Staffing initiatives with legislators and employers;
• Host a national Safe Staffing Conference in 2008 in conjunction with a national Safe Staffing Lobby Day;
• Seek support for Safe Staffing legislation from nursing, labor, and consumer organizations;
• Disseminate organizing tools and research that promotes collective nurse activism to improve staffing for patient safety;
• Train and support a network of registered nurses to act as spokespersons and lobbyists for Safe Staffing legislation;
• Provide a web-based national clearinghouse of contract and legislative best practices related to Safe Staffing; and

BE IT FURTHER RESOLVED, that the United American Nurses actively support enactment of the Nurse Staffing Standards for Patient Safety and Quality Care Act in Congress and comparable state level legislation; and

BE IT FURTHER RESOLVED, that the United American Nurses promote and pursue legislative action that assures:

• Establishment and enforcement of minimum direct care Registered Nurses staffing standards that can be adjusted upward based on patient acuity, patient activity, including admissions, discharges, and transfers on each shift, technology levels, staff preparation and experience, and physical environment;
• Requirement of public documentation of staffing by Health Care Institutions with an evaluation at least annually of the Plan and Acuity System by those institutions;
• A reporting process or system that includes standardized public disclosure regarding nurse staffing levels, staffing mix, and patient outcomes, as well as violations of established standards;
• Protection of the rights of Registered Nurses to refuse unsafe patient assignments without being subjected to discipline;
• Additional Medicare and Medicaid reimbursement related to RN staffing costs incurred to comply with legislated staffing standards and/or patient outcomes which are direct results of nursing care;
• Inclusion of agreement to a study to address the use of non Registered Nurses as support staff within their defined scope of practice;
• Inclusion of consequences, such as fees, penalties, and revocation of facility licenses if Health Care Institutions fail to comply with legislated staffing standards; and

BE IT FURTHER RESOLVED, that the United American Nurses’ Political Action Committee will endorse those candidates who pledge support for Safe Staffing legislation that includes staffing standards.