Florida Senate - 2009 SB 1598 By Senator Rich 34-01232-09 20091598__ 1 A bill to be entitled 2 An act relating to nurse staffing; creating s. 3 395.01921, F.S.; providing legislative findings; 4 providing definitions; requiring hospitals to 5 establish a nurse staffing committee; providing the 6 membership of the committee; providing the 7 responsibilities of the committee; requiring the nurse 8 staffing committee to produce an annual nurse staffing 9 plan; requiring the chief executive officer of a 10 hospital to provide written reasons if the plan is not 11 adopted by the hospital; requiring each hospital to 12 post the nurse staffing plan and the nurse staffing 13 schedule and to make them available to patients and 14 visitors upon request; providing an effective date. 15 16 Be It Enacted by the Legislature of the State of Florida: 17 18 Section 1. Section 395.01921, Florida Statutes, is created 19 to read: 20 395.01921 Nurse staffing.— 21 (1) LEGISLATIVE FINDINGS.— 22 (a) The Legislature finds that research evidence 23 demonstrates that registered nurses play a critical role in 24 patient safety and quality of care. The worsening shortage of 25 nurses available to provide care in acute care hospitals has 26 necessitated multiple strategies to generate more nurses and 27 improve the recruitment and retention of nurses in hospitals. 28 The Legislature also finds that evidenced-based nurse staffing 29 that can help ensure quality and safe patient care while 30 increasing nurse satisfaction in the work environment plays a 31 key role in solving an urgent public health issue in this state. 32 Hospitals and nursing organizations recognize a mutual interest 33 in patient safety initiatives that create a healthy environment 34 for nurses and safe care for patients. 35 (b) In order to protect patients, support a greater 36 retention of registered nurses, and promote evidence-based nurse 37 staffing, the Legislature intends to establish a mechanism 38 whereby direct-care nurses and hospital management participate 39 in a joint process regarding decisions about nurse staffing. 40 (2) DEFINITIONS.—As used in this section, the term: 41 (a) “Hospital” has the same meaning as defined in s. 42 395.002. 43 (b) “Acuity” means the level of patient need for nursing 44 care, as determined by the nursing assessment. 45 (c) “Nursing personnel” means registered nurses, licensed 46 practical nurses, certified nursing assistants, and unlicensed 47 assistive nursing personnel providing direct patient care. 48 (d) “Patient care unit” means any unit or area of the 49 hospital in which patient care is provided by registered nurses. 50 (e) “Skill mix” means the number and relative percentages 51 of registered nurses, licensed practical nurses, certified 52 nursing assistants, and unlicensed assistive nursing personnel 53 among the total number of nursing personnel. 54 (3) NURSING STAFFING COMMITTEE; DUTIES.— 55 (a) By September 1, 2009, each hospital shall establish a 56 nurse staffing committee by creating a new committee or by 57 assigning the functions of a nurse staffing committee to an 58 existing committee. Hospital administrative staff shall appoint 59 the members of the nurse staffing committee, and a significant 60 number of the members must be registered nurses who currently 61 provide direct patient care. 62 (b) Primary responsibilities of the nurse staffing 63 committee include: 64 1. The development and oversight of an annual patient care 65 unit and shift-based nurse staffing plan, based on the needs of 66 patients, which shall be used as the primary component of the 67 staffing budget. Factors to be considered in the development of 68 the plan shall include, but need not be limited to: 69 a. The patient census, including the total number of 70 patients in the unit on each shift, and activities such as 71 patient discharges, admissions, and transfers; 72 b. Level of acuity of all patients and nature of the care 73 to be delivered on each shift; 74 c. Skill mix; 75 d. Level of education, training, and experience of the 76 nursing personnel providing care; 77 e. The need for specialized or intensive equipment; 78 f. The architecture and geography of the patient care unit, 79 including, but not limited to, the placement of patient rooms, 80 treatment areas, nursing stations, medication-preparation areas, 81 and equipment; 82 g. Staffing guidelines adopted or published by national 83 nursing professional associations, specialty nursing 84 organizations, and other professional health care organizations; 85 and 86 h. Hospital finances and resources. 87 2. A semiannual review of the staffing plan against patient 88 needs and known evidence-based staffing information, including 89 the nursing-sensitive quality indicators collected by the 90 hospital. 91 3. The review, assessment, and response to staffing 92 concerns presented to the committee. 93 (c) The committee shall produce the hospital's annual nurse 94 staffing plan. If this staffing plan is not adopted by the 95 hospital, the chief executive officer shall provide a written 96 explanation of the reasons to the committee. 97 (d) Each hospital shall post in an employee area on each 98 patient care unit the nurse staffing plan and the nurse staffing 99 schedule for that shift on that unit, as well as the relevant 100 clinical staffing for that shift. The staffing plan and current 101 staffing levels must also be made available to patients and 102 visitors upon request. 103 Section 2. This act shall take effect July 1, 2009.