PA Safe Staffing Bills

Pennsylvania’s Proposed Legislation for Nurse-to-Patient Ratios

Nurse-to-patient ratios are the best way to ensure safe staffing and effective care for patients. Studies have shown that proper staffing saves lives, reduces errors, decreases complications, and improves patient satisfaction, while also reducing nurse fatigue and burnout.

As PASNAP has worked to organize new unions and give a voice to more nurses, we’ve heard again and again that staffing is a chief concern: In recent surveys from these newly organized hospitals, nearly 90% of nurses cited inadequate and unsafe staffing as a main cause of stress in their day-to-day work lives. PASNAP has worked hard to address this issue with strong contract language, but — with more hospital managers cutting corners and prioritizing profits over patients — it remains a serious concern at union and non-union hospitals alike.

PASNAP has worked with elected leaders in Pennsylvania to create and push for bipartisan legislation to guarantee minimum staffing standards. HB 1426 and SB 553, sponsored by State Representative DiGirolamo (R-18) and State Senator Daylin Leach (D-17), are modeled on California’s extremely successful 1999 law. These bills would amend the Health Care Facilities Act to establish life-saving minimum nurse-to-patient ratios throughout the hospital.


Minimum Staffing Requirements of the Pennsylvania Hospital Patient Protection Act

These bills would establish minimum nurse-to-patient ratios. Implementation and enforcement would be overseen by the Department of Health. The proposed minimum ratios are in the chart below. Only direct care nurses can be counted in the ratios, and the ratios would cover all shifts. Nothing would preclude any facility from implementing higher nurse staffing levels.

The ratios shown in the Ratios Unit Chart below are the minimums that each hospital must follow in its staffing plan and must be adjusted upwards to reflect actual patient acuity. Click here for text of current Senate bill, currently in the Pennsylvania Senate Public Health and Welfare Committee.

Ratios Unit Chart
Type of Unit Minimum Standard
Operating Room
Trauma Emergency Room
Active Labor Patient
Conscious Sedation
1 RN : 1 Patient
Critical Care in the ER
Critical Care
Intensive Care
Neonatal Intensive Care
Labor and Delivery
Burn Unit
1 RN : 2 Patients
Emergency Room
1 RN : 3 Patients
Other Specialty Units
Pre-surgery, admissions units, ambulatory surgical units
1 RN : 4 Patients
Rehabilitation or Skilled Nursing Facility 1 RN : 5 Patients
Postpartum 1 RN : 6 Patients (3 Couplets)
1 RN : 2 Immediate Postpartum
Well-baby Nursery 1 RN : 5 Patients1 RN : 4 Recently Born

See Studies on Safe Staffing

Unsafe Staffing Is Nurses’ Top Concern

Too often, patients are put at risk and RN licenses are compromised by our profit-driven healthcare system which routinely leaves patients without proper nursing care.

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The U.S. Is Running Out of Nurses

Nurses checked on my mother—and us—multiple times an hour. Without them, we would have fallen apart.

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Victoria, Australia to guarantee minimum nurse-to-patient staffing ratios

“Nurse patient ratios are really important for patient safety,” Ms Hennessy said. “Nurse patient ratios are important because the greater the care and focus nurses are able to give to our patients, we know the better clinical outcomes that they have.”

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