Back to the Future: A Standardized Approach to Delivering Effective Nursing Care

Two federal bills were introduced in the US Congress for the 2011-2012 sessions. The National Nursing Shortage Reform and Patient Advocacy Act (S 992/HR 2187) essentially mandates the nation's hospitals to adopt strict, direct care, nurse-to-patient ratio requirements. The Registered Nurse Safe Staffing Act (S 58/HR 876) addresses organizational accountability to develop and implement unit-specific nurse staffing plans. Whereas both bills cite increased patient safety and promotion of quality patient care as potential positive outcomes, only HR 876 comes close to building in the needed flexibility in decision making, variability in patient care, and nurse education and competency levels.