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Staffing
Adequate staffing is best for nurses and patients!
Connecticut Nurses' Association continues to address nurse staffing issues through addressing staffing, pipeline development, and retention strategies.
PA 23-204 includes Updated Hospital Staffing Committee Requirements
Read the full public act click the link below and go to sec. 54.
Please note underlined areas are "new" and items in {} are deleted.
HB 6941 Governor's Budget - Staffing in Section 54 p. 99
2023 Safe Staffing Law Journey
SB 1067: Vehicle for safe staffing initially proposed changes to current staffing committee to be implemented in five years, and included adding a nurse to patient ratio to the staffing PLAN - with no over site, accountability, or penalties for not following the ratios in the plan.
SB 1067 Written Testimony CT Nurses Association
Listen/watch to CT Nurses Association Testifying
SB 1067 all Written Testimony on the Bill
CNA testimony provided the path forward for a non partisian, solutions oriented, immediate change approach and work with AFT CT, CHA, Public Health Committee, Nurse Specialty Organizations, and the Governor's office to refine the bill and develop consensus.
The bill was killed in judiciary committee
The full proposed changes to the bill was finally added in the last days of the session to the Governor's budget and passed. See above for bill number and text.
We thank nurses, nurse specialty organizations, and our AFT partners who were instrumental in bringing the voice of nurses to Hartford, and we thank the legislative leadership and state agencies for fully exploring and supporting solutions.
Nurses need to be at the every table where health decisions are being made!
History of Nurse Staffing in Connecticut CT Gen Stat § 19a-89e.
2008 Development of prospective nurse staffing plan by hospitals - established safe staffing committee
2015 Updated to include annual reporting to DPH of staffing plan.
SB 1067 Written Testimony CT Nurses Association
Listen/watch to CT Nurses Association Testifying
SB 1067 all Written Testimony on the Bill
Highlights of the 2023 Hospital Staffing Committee
Requirements and Responsibilities
DEDICATED STAFFING COMMITTEE
· Modified composition to be 50%+1, in favor of direct care nurses (Collective bargaining picks direct care nurses)
· Require co-chairs of committee, one being direct care nurse
· Establish unit based ratios and evidence based criteria
· Required to provide compensation and unit coverage for nurse participation
STAFFING PLAN
· Includes unit ratio for direct care RN, LPN, and assistive personnel
· Increase reporting to DPH from annually to biannually.
· Expands required components of the plan
· Reviews related data (ie hospital hiring, turnover rates, etc.)
TRANSPARENCY
· Nurses are informed at hire and annually about staffing committee, meeting schedule, participation, and communication
· Staffing Plan posted in a visible location to the public on each patient care unit.
ACCOUNTABILITY
· Bi-annually hospitals report to DPH on their compliance with expectation to implement staffing plan ratios 80% of the time
· DPH has authority to investigate complaints about staffing, and adherence to the staffing plan
· DPH has authority to impose a corrective action plan and penalties for inability to meet staffing ratios in their hospital
RETALIATION PROTECTION
· Protection for nurses to share their voice about unsafe staffing, or workplace violence, racism or bullying
· No hospital shall require a registered nurse to undertake any patient care task that is beyond the scope of the nurse's license
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AMERICAN NURSES ASSOCIATION
ANA summarizes the Safe StaffingSafe staffing can be a matter of life and death and nurses and management working collaboratively is critical to achieving the right staffing levels. Adding additional registered nurse (RN) hours to unit staffing has been shown to reduce the relative risk of adverse patient events, such as infection and falls. Reducing medical errors is also important from a financial perspective, as the Centers for Medicare & Medicaid Services (CMS) continues to advance value-based care models that incorporate risk-sharing that withholds payment for preventable hospital-acquired injuries or illnesses. Increasingly, value-based care models are being adopted across all payers, including private insurers.
· Collaborative efforts among state hospital associations, nurse executives, and ANA-affiliated state nurses associations have resulted in state level safe staffing laws designed to benefit both patients and nurses. Seven states have enacted staffing legislation applying ANA’s hospital-wide committee approach: Oregon (2002), Texas (2009), Illinois (2007), Connecticut (2008), Ohio (2008), Washington (2008), and Nevada (2009).
ANA continues to work with federal lawmakers and the Administration on this vital issue, supporting a bipartisan approach toward safe nurse staffing levels.
Safe staffing approaches that increase the number of RNs per patient results in improved clinical and economic outcomes. Adopted approaches must recognize the unique characteristics associated with each hospital and unit within, including:
• RN educational preparation, professional certification, and level of clinical experience;
• the number and capacity of available health care personnel, geography of a unit, and available technology; and
• the intensity, complexity, and stability of patients.
ANA continues to advocate for safe staffing approaches that:
• provide assurance that RNs are not forced to work without orientation in units in which they are not adequately trained or experienced;
• establish procedures for receiving and investigating complaints;
• allow for civil monetary penalties for known violations;
• include whistleblower protections; and
• require public reporting of staffing information.
A balanced approach to promote the development and implementation of valid, reliable, unit-by-unit nurse staffing plans ensure robust patient safety and optimal health outcomes. More information, research, and data about nurse staffing advocacy is available on nursingworld.org.
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
Staffing and the COVID Pandemic Impact