Nurses often become motivated to change aspects within the larger health care system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger health care system. For this assignment, identify a problem or concern in your state, community, or organization that has the capacity for advocacy through legislation. Research the issue and use the “Advocacy Through Legislation” template to complete this assignment. You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.


Nurses are uniquely positioned to advocate for change within the healthcare system due to their firsthand experience in providing direct patient care. Advocacy through legislation allows nurses to address issues and concerns at a systemic level by influencing regulations, policies, and laws. This assignment aims to identify a problem or concern in the state, community, or organization and propose advocacy through legislation as a means to bring about change. By conducting research and using the “Advocacy Through Legislation” template, nurses can effectively formulate a plan to address the identified problem or concern.

Problem or Concern:

The problem or concern selected for this assignment is the lack of standardized nurse staffing ratios in acute care settings. Nurse staffing ratios refer to the number of patients assigned to each nurse, and they have a significant impact on patient outcomes, nurse job satisfaction, and safety. Insufficient nurse staffing ratios have been associated with increased rates of adverse events, medication errors, patient mortality, and nurse burnout (Aiken et al., 2014).

Inadequate nurse staffing ratios are particularly prevalent in busy urban hospitals, where high patient volumes and complex care requirements can overwhelm nurses. Without standardized ratios, nurse staffing decisions are often driven by financial considerations rather than patient care needs. This can result in understaffing, excessive workloads, and compromised patient safety. Furthermore, inadequate nurse staffing can contribute to higher nurse turnover rates, which further exacerbates staffing challenges (Kane et al., 2007).


To support the need for advocacy through legislation regarding nurse staffing ratios, several recent studies have provided evidence of the impact of inadequate staffing on patient outcomes and nurse well-being. Aiken et al. (2014) conducted a cross-sectional study across five countries and found that each additional patient assigned to a nurse was associated with a 7% increase in the likelihood of patient mortality. The study also revealed that inadequate staffing was a major contributor to nurse burnout and job dissatisfaction.

Another study by Kane et al. (2007) examined the effects of nurse staffing ratios on patient safety in hospitals. They found a significant reduction in adverse events, medication errors, and patient mortality when nurse staffing was adequate. These findings highlight the importance of standardized staffing ratios in promoting patient safety and quality of care.

In addition to empirical research, professional organizations and nursing associations have voiced their support for legislation mandating nurse staffing ratios. The American Nurses Association (ANA) has identified safe nurse staffing as a priority and advocates for state and federal laws to establish minimum nurse-to-patient ratios. The ANA argues that evidence-based staffing ratios are essential to protect patient safety, ensure nurse well-being, and promote positive patient outcomes (ANA, 2019).

Advocacy Through Legislation:

To address the problem of inadequate nurse staffing ratios, advocacy through legislation is crucial. The goal is to develop and implement state-level legislation that mandates minimum nurse-to-patient ratios in acute care settings. By establishing standardized ratios, nurses will have the necessary resources and staffing support to provide safe and high-quality care.

The first step in advocacy through legislation is to gather support from key stakeholders. This includes mobilizing fellow nurses, nursing organizations, and other healthcare professionals who recognize the importance of safe nurse staffing. Collaboration with legislators who are sympathetic to the cause and have the ability to introduce legislative proposals is also essential.

Once support has been secured, the next step is to draft a bill that specifies the desired nurse-to-patient ratios and outlines the consequences for non-compliance. The bill should be based on evidence from research studies, professional organizations, and input from frontline nurses. It should also address concerns raised by opponents, such as potential financial implications on healthcare facilities.

Following the drafting of the bill, it is crucial to engage in advocacy efforts to promote its passage. This involves contacting legislators, testifying at legislative hearings, and educating the public on the importance of safe nurse staffing ratios. Collaboration with local media outlets can help raise awareness and garner public support for the proposed legislation.


Advocacy through legislation is a powerful tool for nurses to address problems and concerns within the healthcare system. By identifying the lack of standardized nurse staffing ratios as a critical issue, nurses can advocate for legislation mandating minimum ratios in acute care settings. Evidence from research studies, support from professional organizations, and collaboration with key stakeholders are vital components of this advocacy effort. By working together, nurses can bring about positive change that ensures patient safety, improves nurse job satisfaction, and enhances overall healthcare outcomes.