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SR112
THE SENATE
S.R. NO.
112
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII
SENATE RESOLUTION
REQUESTING THE HAWAII STATE CENTER FOR NURSING TO CONDUCT
A STUDY COMPILING RECOMMENDED SAFE PATIENT STAFFING RATIOS
.
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WHEREAS, the
issue of safe staffing in hospitals has escalated into a growing public health
concern in Hawaii and other states across the nation and can no longer be
defined as strictly a collective bargaining issue; and
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WHEREAS, the
nursing community is the largest segment of Hawaii's health care workforce and
is indispensable to the health, safety, and well-being of the residents of the
State; and
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WHEREAS, as
more care is delivered in outpatient or home and community-based settings, the
acuity of patients who are admitted to hospitals has intensified, requiring
significantly more attention, complex monitoring, and clinical intervention by
frontline nurses; and
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WHEREAS, the
Legislature commissioned the Legislative Reference Bureau to conduct a
comprehensive study on nurse staffing pursuant to House Concurrent Resolution
No. 187 (2024); and
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WHEREAS, the
Legislative Reference Bureau submitted its 2025 report,
Time for Triage:
�
A Summary of Best Practices, State
Requirements, and Successful Efforts to Reduce Nurse Staffing Shortages
,
which cited several studies demonstrating that patient outcomes improve with
higher nurse staffing ratios, or nurse-to-patient ratios, through results such
as shorter hospital stays, fewer complications, fewer readmissions, less risk
of death, reduced hospital-acquired infections, increased patient satisfaction,
improved patient compliance with treatment plans, improved pain management, and
fewer medication errors, and that nurse staffing ratios may be especially
important for patients of color; and
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WHEREAS, the
Joint Commission, the nation's leading health care accrediting body, has
established National Performance Goal 12, effective January 1, 2026, which
formally recognizes that hospital staffing levels and competencies must align
with patient needs as a critical component of clinical quality and patient
safety; and
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WHEREAS, data
from the 2025 Hawaii Nursing Workforce Supply Statewide Report and the 2026
Informational Brief on The State of Hawaii's LPN and RN Workforces by the
Hawaii State Center for Nursing show there is an adequate number of registered
nurses in the islands to meet existing demand, indicating the number of registered
nurses statewide is not a barrier to safe staffing; and
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WHEREAS, the
Hawaii State Center for Nursing reports findings from a 2023 Nursing Wellbeing,
Recruitment, and Retention Strategic Initiative Working Group literature review
that Hawaii registered nurses felt so stressed at work that they considered
leaving the nursing profession, and that nurses increasingly indicated physical
and mental health as leading contributors to their desire to leave the
workforce; and
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WHEREAS, creating
supportive work environments with safe staffing levels is essential to
attracting the next generation of nurses to Hawaii's workforce and retaining
the experienced nurses currently practicing in Hawaii's health care facilities;
and
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WHEREAS, transparency
in staffing standards allows for better-informed decision-making by health care
providers, policymakers, and the public; now, therefore,
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BE IT
RESOLVED by the Senate of the Thirty-third Legislature of the State of Hawaii,
Regular Session of 2026, that the Hawaii State Center for Nursing is requested
to conduct a study to compile a comprehensive list of recommended safe patient
staffing ratios for various hospital units and health care settings; and
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BE IT FURTHER
RESOLVED that the Hawaii State Center for Nursing is requested to use the
specific unit-by-unit staffing standards and ratio requirements outlined in
House Bill No. 1865 (2026) and Senate Bill No. 2763 (2026) as the foundational
framework for the study that compiles the staffing standards recommended by
professional specialty organizations, including but not limited to the:
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(1)
�
American
Association of Critical-Care Nurses;
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(2)
�
Emergency
Nurses Association;
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(3)
�
Association
of Women's Health, Obstetric and Neonatal Nurses;
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(4)
�
American
Society of PeriAnesthesia Nurses;
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(5)
�
Association
of periOperative Registered Nurses;
����
(6)
�
Oncology
Nursing Society;
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(7)
�
Academy
of Medical-Surgical Nurses;
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(8)
�
American
Psychiatric Nurses Association;
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(9)
�
Society
of Pediatric Nurses; and
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(10)
�
American
Nephrology Nurses Association;
and
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BE IT FURTHER
RESOLVED that the Hawaii State Center for Nursing may, in consultation with its
advisory board, include in the study standards for a nursing specialty or
sub-specialty established or recommended by regulation or statute in other
states, recognized authorities in other countries, and other professional
associations; and
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BE IT FURTHER
RESOLVED that the Hawaii State Center for Nursing is requested to submit the
study, including any findings, recommendations, and proposed legislation, to
the Legislature and Department of Health and publish the study in a publicly
available online dashboard no later than twenty days prior to the convening of
the Regular Session of 2027; and
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BE IT FURTHER
RESOLVED that this body urges Hawaii's health care facilities to use every
effort to implement safe patient staffing ratios that reflect the standards
compiled and tracked by the Hawaii State Center for Nursing; and
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BE IT FURTHER
RESOLVED that certified copies of this Resolution be transmitted to the
Director of Health, who in turn is requested to submit copies of this measure
to the Chief Executive Officers of each hospital and health care facility
licensed in the State; and the Executive Director of the Hawaii State Center
for Nursing.
OFFERED BY:
_____________________________
Report Title:
�
Hawaii
State Center for Nursing; Staffing Ratios; Study