Enforcement of Hospital Nurse Staffing Regulations Across the United States: Progress or Stalemate?

Enactment of hospital nurse staffing regulations was brought about by changes in the U.S. health care system that resulted in large-scale reductions in nurse staffing. These reductions came at a time when studies were highlighting inadequacies in care that caused negative patient outcomes and raised questions about the safety of hospitalized patients. Nurse staffing regulations were enacted to ensure that adequate numbers of nurses were available to provide high-quality and safe care. Although these regulations represent progress toward addressing staffing inadequacies, enforcement language is absent or weak and compliance data are either not collected or difficult to access. Explicit and funded enforcement measures need to be included in staffing regulations. Additionally, compliance monitoring and reporting are necessary to evaluate these types of staffing regulations and to determine if they actually achieve the goal of appropriate nurse staffing.