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Statement: Safe staffing key to quality healthcare

An appropriate number of nurses and other staff should be available at all times across the continuum of care, with a mix of education, skills and experience to ensure patient care needs are met and working conditions stay hazard-free, according to a policy statement on safe staffing levels released July 15 by the International Centre for Human Resources in Nursing in Geneva, Switzerland.

“It is well known that nurse staffing affects the patient’s length of stay in hospital, morbidity and mortality and their reintegration into the community,” Judith Shamian, president of the International Council of Nurses, said in a news release. “In addition, safe staffing levels are associated with improved retention, recruitment and workforce sustainability as well as better cost efficiency for the healthcare system — in short this is essential to the functioning of all health services.”

The policy statement, which was prepared with the ICN International Workforce Forum, sets out key principles that underpin safe staffing levels. These principles include:

• Ensuring the safe delivery of care should be the main consideration in healthcare staffing decisions.

• Safe staffing means care is delivered without harm to either patients or staff.

• Safe staffing takes into account not only numbers of staff and mix of competencies, but also other variables such as a manageable workload, a responsive and supportive workplace culture, adequate supervision, appropriate training and a range of high-quality facilities and equipment.

For the full policy statement, visit

The ICN’s 2006 International Nurses Day Toolkit on Safe Staffing is available for download at

Launched by the International Council of Nurses and the Florence Nightingale International Foundation in 2006, ICHRN is dedicated to strengthening the nursing workforce globally through the development, ongoing monitoring and dissemination of comprehensive information, standards and tools on nursing human resources policy, management, research and practice.

By | 2013-07-25T00:00:00-04:00 July 25th, 2013|Categories: National|1 Comment

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    Katrina July 8, 2020 at 7:46 pm - Reply

    Hello, my name is Katrina. I am a registered nurse in Dutchess County, NY, U.S. I am also a student at SUNY Plattsburgh completing an RN to BSN program. Thank you for your efforts to draw attention and educate other nurses and the public regarding safe staffing.

    I myself am currently advocating for NYS assembly passing bill A01532, the Safe Staffing Quality Care Act. The correlation between adequately staffed nursing departments and positive patient outcomes has been substantially documented within scholarly nursing literature. What studies have found is that for each understaffed shift that occurs it increases a patient’s risk of death by 2% (Helfrich et al., 2017). It also increases risk for falls, pressure ulcers, medication errors, and missed tasks by nurses (Needleman et al., 2011; He et al., 2016). All of this then results in patient perceived lower quality of care (Qureshi et al., 2019).

    In the US through the offices of Medicaid and Medicare reimbursement has been modified based off of lower quality care, lower patient satisfaction, and readmission rates (Mason et al., 2016). According to Mason et al. (2016), nursing accounts for approximately half of labor budgets in most hospitals, making nursing labor an enticing area to reduce cost. However, quality of care, patient satisfaction, and readmission rates all directly tie into nursing care.

    California currently has state mandated nurse to patient ratios (NPRs). Due to mandated NPRs, nurses in California have reported an increase in completion of nursing tasks with improvement of quality patient care (Aiken et al., 2010). Additionally, with mandated NPRs, California has been able to actually increase hospital revenue as a result of decreasing costly complications, and complete documentation (Aiken et al., 2010).

    I am hoping adding to your blog will assist in educating and advocating for safe staffing, not just in New York State, but across the globe. Thank you for the ability so share on your blog!


    Aiken, L., Sloane, D., Cimiotti, J., Clarke, S., Flynn, L., Seago, J., Spetz, J., & Smith, H. (2010). Implications of the California nurse staffing mandate for other states. Health Services Research, 45(4), 904–921.

    He, J., Staggs, V., Bergquist-Beringer, S., & Dunton, N. (2016). Nurse staffing and patient outcomes: A longitudinal study on trend and seasonality. BioMed Central Nursing, 15(60), 1–10.

    Helfrich, C., Simonetti, J., Clinton, W., Wood, G., Taylor, L., Schectman, G., . . . Nelson, K. (2017). The association of team-specific workload and staffing with odds of burnout among VA primary care team members. Journal of General International Medicine, 32(7), 760–766.
    Mason, D. J., Gardner, D., Outlaw, F., O’Grady, E. (Eds.). (2016). Policy and politics in nursing and health care. 7th ed. St. Louis, MO: Saunders.

    Needleman, J, Buerhaus, P., Pankratz, S., Leibson, C., Stevens, S., & Harris, M. (2011). Nurse staffing and inpatient hospital mortality. New England Journal of Medicine, 364(11), 1037–1045.

    Qureshi, S., Purdy, N., Mohani, A., & Neumann, P. (2019). Predicting the effect of nurse–patient ratio on nurse workload and care quality using discrete event simulation. Journal of Nursing Management, 27(5), 971– 980.

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