Emergency Nurses Association
Public Policy Agenda: 2020/2021

I. Safety in the Emergency Care Environment

Reduce Violence Against Emergency Nurses

Violence in emergency departments has reached epidemic levels and emergency nurses are particularly vulnerable. The 24-hour accessibility of the emergency department; the lack of adequately trained, armed or visible security guards; and an overall stressful environment are among the chief reasons why emergency nurses are victims of violence at such a high rate.

The Emergency Nurses Association (ENA) will continue to advocate for state laws that strengthen the criminal penalties for assaulting or battering emergency nurses and other health care workers in emergency departments.

ENA will also support legislation and regulations to prevent workplace violence and ensure the safety of patients and workers in health care facilities. These efforts should include the enhanced training of workers in identifying and addressing risk factors that make emergency departments vulnerable to violence, as well as policies that encourage the reporting of violent incidents and prevent employer retaliation against nurses who are the victims of workplace violence.

Reduce Workplace Injury

Nurses are at risk of harm from the environment in which they work. Factors influencing this situation include ergonomic injuries, needle stick injuries, increasing patient obesity rates and an aging workforce.

ENA will support federal legislation and programs aimed at reducing workplace injuries and illnesses for health care personnel and patients, while improving the safety of patient care delivery.

Establish Safe Emergency Department Staffing Guidelines

Maintaining the appropriate level of emergency nursing staff is critical to the ability of emergency departments to provide quality health care for patients.

As such, ENA supports policies that empower nurses to create appropriate staffing plans specific to each emergency department. This approach recognizes the many factors that determine the appropriate level of staffing, as well as the flexibility needed to account for changing circumstances in emergency departments.

II. Nursing Education and Practice

Increase Funding for Nursing Education and Training

ENA urges Congress to increase its investment to alleviate the growing nursing shortage that is impacting every aspect of the U.S. health care system and negatively affecting patient care.

ENA will support legislation that reauthorizes and funds the Nursing Workforce Development programs under Title VIII of the Public Health Service Act. The Title VIII programs provide the main federal funding for nursing education, practice and retention.

Protect Emergency Nursing Scope of Practice and Support Full Practice Authority for Advanced Practice Registered Nurses

ENA will support public policies that remove restriction on the role and scope of practice of Registered Nurses (RNs) and Advanced Practice Registered Nurses (APRNs) in appropriate health care settings. ENA will support efforts to allow these professionals to practice to the full extent of their education and training.

ENA will support legislation that allows APRNs to practice autonomously and independently prescribe medication and oppose restrictions on the administration of procedural sedation medications by qualified emergency nurses.

Protect the Integrity of the Nurse Title

ENA will support efforts to ensure that the title of “nurse” is reserved for those who have attained the requisite state standards of education, training and licensure for nurses.

III. Quality and Timely Access to Emergency Care

Support Programs to Enhance Access and Improve Care for Patients with Mental Illness

ENA will support policies aimed at enhancing access and improving care for patients experiencing mental illness. Further, ENA supports policies that alleviate the holding or boarding of such patients in the emergency department.

Support Programs to Improve Identification and Treatment for Patients At Risk of Suicide

Suicide rates across the nation rose 31 percent between 2001 and 2017. In 2017, suicide was the tenth leading cause of death in the U.S. ENA research indicates that taking steps to improve suicide risk assessment in the emergency department could increase the number of patients with suicidal ideation who are identified.

ENA will support policies to improve care for patients at risk of suicide, including efforts to improve screening and assessment, as well as enhance emergency department discharge planning and procedures to encourage this patient population to seek appropriate follow-up care.

Support Programs to Improve Training for Health Professionals Related to Human Trafficking and Sexual Assault

ENA will also support efforts to assist and provide high-quality care for other vulnerable patient populations, such as victims of human trafficking and sexual assault. ENA will support enhancing education and training for emergency nurses in treating these patients.

Increase Support for Trauma Systems and Trauma Centers

Trauma is the leading cause of death for people under the age of 46 and 35 million people are treated for traumatic injuries every year. Nevertheless, more than 45 million people lack access within one hour to a trauma center able to treat severe traumatic injuries.

ENA will continue to fight for legislation and funding to improve trauma care in the United States. This includes both the development of optimally functioning trauma systems and quick access to state-of-the-art trauma centers.

Maintain Funding for Poison Control Centers

According to the Centers for Disease Control and Prevention, more than 40,000 people die annually from poisoning and approximately 2,000 are treated each day in emergency departments.

ENA will support programs and funding that provide resources for the nation’s 55 poison control centers and the national poison control hotline.

Improve Treatment of Patients Who Abuse Opioids and Other Drugs

The U.S. is experiencing a historic epidemic in opioid abuse and related overdose death. In 2018, drug overdoses were the leading cause of accidental death in the United States.

ENA will support policies and federal funding to combat the ongoing national crisis of opioid addiction and overdose death, including provisions to encourage states and local communities to pursue a full array of proven strategies to combat addiction and support individuals in recovery.

Fund Research to Improve the Delivery of Emergency Care

ENA will continue to strive for improved patient safety and enhanced quality of care by collaborating with appropriate stakeholders to promote and conduct research to enhance emergency care for all patients.

In addition, ENA will support the work of the National Institute of Nursing Research (NINR) at the National Institutes of Health (NIH) and urges adequate federal funding for NINR within the overall NIH budget.

Continue and Expand Federal Research and Support for Pediatric Emergency Care

ENA will strongly support policies that will enhance emergency medical services for children. As such, ENA urges Congress to continue to support the Emergency Medical Services for Children (EMSC) program at the Health Resources and Services Administration. EMSC, which has provided funds to every state, is the only federal program dedicated to improving emergency care for children.

ENA will support legislation that reauthorizes and provides adequate federal funding for the EMSC program.

Expand Training and Resources for Stop the Bleed Campaign

ENA will support federal and state efforts to expand the distribution of anti-blood loss supplies and the training and equipping of bystanders to help in a bleeding emergency before professional help arrives.

IV. Injury Prevention

Support Federal and State Initiatives to Enhance Highway and Auto Safety and Other Injury Prevention Measures

ENA will support legislation at the federal and state levels which enhance the safety of drivers and passengers in motor vehicles, including efforts to increase the usage of safety devices in cars and limit the size and weight of trucks. Where appropriate, ENA will advocate on behalf of other injury prevention bills that will result in significant health care benefits to the public.

Support Research and the Reporting of Information Related to Firearms

ENA will support federal funding for firearms-related research at CDC and HHS.

ENA will advocate for the extension of the National Violent Death Reporting System to include all U.S. state and territories.

ENA will also support legislation requiring all firearms sales in the United States to include a background check on the purchaser.