The Future of Nursing 2020-2030 Report created by the National Academies of Sciences, Engineering, and Medicine produced a consensus report via an ad hoc committee that maps a path for the nursing profession to help our nation create a culture of health, reduce health disparities and improve the health and well being of the U.S. population. 

Review the chapter that is ATTACHED (BRIFLY READ IS LONG) In relation to health policy development, identify an advanced practice nurse initiative, policy, law, regulation that is being promoted by a state or federal nursing organization. Research the area of concern and discuss two of the following.

THE POLICY I PICKED IS: Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (DOCUMENT IS ATTACHED)


  • The goals of the goals of the recommended action.
  • Target possible stakeholders who would benefit from the recommendations and those organizations which may become allies.
  • Describe tactics that advanced practice nurses could implement to improve political engagement of their coworkers. 





There are no federal mandates regulating the number of patients a registered nurse can care for at
one time in U.S. hospitals. As a result, registered nurses (RNs) are consistently required to care for
more patients than is safe, compromising patient care and negatively impacting patient outcomes.
This legislation would protect patients and improve health care by setting mandated, minimum,
registered nurse-to-patient staffing ratios.

Low nurse staffing levels are extremely dangerous for patients
» Studies show that when RNs are forced to care for too many patients at one time, patients are

at higher risk of preventable medical errors, avoidable complications, falls and injuries, pressure
sores, increased length of stay, and readmissions.1 In addition, RNs experience higher burnout
rates and job dissatisfaction.2

» For each additional surgical patient in an RN’s workload above the baseline nurse-to-patient
ratio of 1:4, the likelihood of patient death within 30 days increases by 7 percent.3

» A 2006 study showed that if all hospitals increased RN staffing to match the best-staffed
hospitals in the country, 5,000 in-hospital patient deaths and 60,000 adverse patient outcomes
could be avoided.4

Studies on California’s RN-to-patient ratios statute — the only law of its kind in the
country — confirm the significant impact minimum staffing ratios have on improved
patient safety and outcomes
» Compared to California, New Jersey hospitals would have 13.9 percent fewer patient deaths

and Pennsylvania 10.6 percent fewer deaths if they matched California’s ratios in medical-
surgical units.5

» Compared to states without ratios, California RNs report having more time to spend with
patients and that hospitals are more likely to have enough RNs on staff to provide quality
patient care.6

Safe RN-to-patient ratios are cost-effective for hospitals
» Ratios will reduce spending on temporary RNs and overtime costs,7 lower RN turnover,8

improve patient outcomes,9 and shorten patient lengths of stay.10
» A 2009 study estimated that adding 133,000 RNs (the

number of RNs needed to increase nursing staff to the
75th percentile) to the U.S. hospital workforce would
result in medical savings of $6.1 billion on health care
spending, not including the value of increased productivity
when RNs help patients recover more quickly.11

» Combining medical savings with increased productivity,
the addition of 133,000 RNs would result in an economic
value of $57,700 for each additional RN.12

Nurse Staffing Standards for Hospital
Patient Safety and Quality Care Act
S. 1567 Senator Sherrod Brown
H.R. 3165 Representative Jan Schakowsky

OUR PATIENTS. OUR UNION. OUR VOICE. » NationalNurses » @NationalNurses



All downloadable National Academies titles are free to be used for personal and/or non-commercial
academic use. Users may also freely post links to our titles on this website; non-commercial academic
users are encouraged to link to the version on this website rather than distribute a downloaded PDF
to ensure that all users are accessing the latest authoritative version of the work. All other uses require
written permission. (Request Permission)

This PDF is protected by copyright and owned by the National Academy of Sciences; unless otherwise
indicated, the National Academy of Sciences retains copyright to all materials in this PDF with all rights

Visit the National Academies Press at and login or register to get:

– Access to free PDF downloads of thousands of publications

– 10% off the price of print publications


– Special offers and discounts




This PDF is available at

The Future of Nursing 2020-2030:
Charting a Path to Achieve Health
Equity (2021)

466 pages | 6 x 9 | PAPERBACK

ISBN 978-0-309-68506-1 | DOI 10.17226/25982

Mary K. Wakefield, David R. Williams, Suzanne Le Menestrel, and Jennifer Lalitha
Flaubert, Editors; Committee on the Future of Nursing 2020 2030; National
Academy of Medicine; National Academies of Sciences, Engineering, and Medicine

National Academies of Sciences, Engineering, and Medicine 2021. The Future of
Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC:
The National Academies Press.

The Future of Nursing 2020-2030 Report

            In 2010, the Institute of Medicine, in collaboration with the Robert Wood Johnson Foundation, released the famous “The Future of Nursing: Leading Change, Advancing Health” report. This report helped shed light on the crucial role of nurses as members of healthcare in transforming healthcare. Recently, the Institute of Medicine released “The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity.” This report highlights the role of nurses in the next decade, especially as it regards achieving health equity. A lot of social determinants of health are to blame for the various health disparities reported in the country. Nurses are responsible for reducing those health disparities and promoting health in the country (National Academies of Sciences, Engineering & Medicine, 2022).

            The American Nurses Association (ANA) has been widely involved in advocacy efforts to address health disparities and improve public health and safety. Among the areas that ANA is trying to address is gun violence in the country. Gun violence is a significant public health and safety issue. Each day, 321 Americans are shot across the United States. Among those, 111 are killed (Brady Campaign to Prevent Gun Violence, 2022). Cases of the mass shooting have significantly increased over the years. Thus, ANA is among the organizations raising concern over the country’s increased gun violence cases. ANA is calling for commonsense reforms on guns. These reforms will help keep guns out of the wrong hands. People with a history of violence, convicted felons, and those with mental illness should not have access to guns. Thus, strengthening background checks will help a lot in ensuring only law-abiding citizens have access to guns. Further, ANA calls for further investment in mental health. A lot of cases, including mass shootings, homicides, and suicides by guns, are attributed to mental illness. Thus, it is vital for the government to invest more in mental health care (American Nurses Association, 2022).

            Every American adult and child will benefit a lot from the legislation of stricter gun control laws. Both adults and children have suffered the impact of gun violence. Cases of school shootings, malls, and churches affect everyone. Thus, Americans will benefit first. There are a lot of nonprofit organizations working to address the problem of gun violence in our society. These organizations will make good allies. Examples of such organizations include Moms Demand Action for Gun Sense in America, Gun Free Kids, Mayors against Illegal Guns, Brady Campaign to Prevent Gun Violence, and Everytown for Gun Safety, among others (Brady Campaign to Prevent Gun Violence, 2022).

            Bringing more nurses together can help in amplifying the nurses’ call for policy change. An advanced practice nurse needs to involve coworkers in political advoca