Nurse Staffing Standards for Patient Safety

Bill Provision

The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2019 seeks to amend the Public Health Service Act by introducing a specific patient-nurse staffing ratio condition for direct personalized services in hospitals. The United States of America House of Representatives and Senate have a mandate to enact this proposed law. This paper discusses the bill’s provision and its anticipated effects on nurses.

This bill needs hospitals to adopt and comply with the staffing plan developed by the Department of Health and Human Services (HHS), which needs nurses to be organized according to the minimum stated patient-to-nurse ratio. Hospitals are obliged to follow stipulated procedures regarding ratios, as well as forbidding unqualified people from performing nursing duties unless authorized within a certain scope. In addition, the Medicare payment methods for hospitals have to be altered to cover the additional costs incurred when complying with the suggested ratios. The bill also gives nurses options of either refusing or objecting to participating in work that violates the stipulated nursing-patient proportion or involves those that may jeopardize the safety of a sick person due to a lack of experience or basic education.

Hospitals are not supposed to terminate a nurse for refusal to undertake an assignment or discriminate against a person for good faith-based issues associated with services, care, or hospital situations. The HHS may impose monetary penalties on healthcare facilities violating the ratios and also publish hospitals’ names. The bill also obliges nurses to be given allowance and stipend for further studies under the workforce loan repayment and scholarship program, it also advocates for a nurse retention grant program to cover mentorship projects and nurse preceptorship projects.

History, Reflection, and Bill Importance

There is a need for the federal government to promote quality of care and improve health care service delivery in the United States. The changes made by Medicare, Medicaid, and Obama care over the years have led to an increase in the number of sick persons visiting the hospitals. Consequently, the nurses’ patient ratio at the hospitals is high, and nurses are overworked due to shortages (Bridges et al., 2019). Poor staffing practices and the presence of few qualified nurses has jeopardized citizens’ life and lowered the quality of health care delivery.

The bill was introduced in the house on 5th August 2019 by Janice Schakowsky. It is supported by several houses of senate individuals such as David Joyce, Suzan DelBene, Suzanne Bonamici, Tulsi Gabbard, and Jeff Merkley. The act was first referred to the Energy Subcommittee and later to the Energy and Commerce Committee. It was later passed to the Houses Ways and Means followed by House Energy Commerce before the introduction phase.

The key stakeholders in this bill include hospitals, nurses, and patients. Nurses are supporting this legislation because they have experienced fatigue due to understaffing, which has been the major cause of turn-outs and medical errors that have risked people’s life. On the other hand, private hospitals and nursing homeowners are opposing the proposed legislation. It is estimated that a nursing home may spend about $1.06 billion to implement the law (Vuong, 2020). Thus, the objection is justified because business people in the healthcare industry are anticipating the loss of revenue when adopting the proposed act.

The staffing requirements are costly to institutions of healthcare since more nurses will have to be employed, trained, and oriented before undertaking their duties. In addition, this legislation may lead to an increase in Medicaid costs and later lower quality of life for patients who may not afford insurance. Nevertheless, the advantage of this proposed action is that the outcomes of care delivery will improve.

Nurses need to educate citizens, representatives, and senators on the importance of safe staffing during forums. Healthcare workers must advocate for this bill in their communities and when interacting with people of other professions. Since the proposed act is dependent on legislators’ votes, they should use their expertise to persuade elected officials to support it. This can be done by sending emails explaining to them the importance of the bill.

Impact on Nurses’ Ability to Provide Safe and Quality Care

A high patient-to-nurse ratio is associated with fatigue, job dissatisfaction, and emotional exhaustion. Understaffed health workers are prone to symptoms such as back pain, irritability, headaches, insomnia, depression, weight gain, and high blood pressure (Olley et al., 2019). These signs result in frequent medical errors, which may lead to prolonged stays in hospitals, death, and poor care outcomes. Therefore, reducing the patient-nurse proportion may mitigate the negative outcomes.

The bill will ensure that nurses are adequately staffed in hospitals to enhance both patients’ and their safety. This will result in the improvement of care outcomes and staff retention. Engaging a qualified registered healthcare worker as per the proposed act leads to more sustainable outcomes. Optimizing Quality and safety is dependent on proper nursing ratios as well as competencies (Vuong, 2020). This implies that the presence of skilled nurses with experience in a decent work environment yields better care.


Bridges, J., Griffiths, P., Oliver, E., & Pickering, R. M. (2019). Hospital nurse staffing and staff–patient interactions: An observational study. The British Medical Association Quality & Safety, 28(9), 706–713.

Olley, R., Edwards, I., Avery, M., & Cooper, H. (2019). Systematic review of the evidence related to mandated nurse staffing ratios in acute hospitals. Australian Health Review, 43(3), 288–293.

Vuong, L. (2020). Staffing ratios and burnout. American Journal of Nursing, 120(5), 13.

Video Voice-over

Cite this paper

Select style


LawBirdie. (2023, October 14). Nurse Staffing Standards for Patient Safety. Retrieved from


LawBirdie. (2023, October 14). Nurse Staffing Standards for Patient Safety.

Work Cited

"Nurse Staffing Standards for Patient Safety." LawBirdie, 14 Oct. 2023,


LawBirdie. (2023) 'Nurse Staffing Standards for Patient Safety'. 14 October.


LawBirdie. 2023. "Nurse Staffing Standards for Patient Safety." October 14, 2023.

1. LawBirdie. "Nurse Staffing Standards for Patient Safety." October 14, 2023.


LawBirdie. "Nurse Staffing Standards for Patient Safety." October 14, 2023.