Florida Senate - 2009                                    SB 1604
       
       
       
       By Senator Aronberg
       
       
       
       
       27-01395-09                                           20091604__
    1                        A bill to be entitled                      
    2         An act relating to nursing services; creating s.
    3         395.01922, F.S.; providing definitions; requiring
    4         hospitals to establish nurse staffing committees;
    5         providing for membership and responsibilities;
    6         requiring committees to produce annual hospital nurse
    7         staffing plans; requiring the chief executive officer
    8         to provide a written explanation for refusal to adopt
    9         a proposed staffing plan; requiring the hospital to
   10         post the adopted nurse staffing plan and nurse
   11         staffing schedule in patient care units; providing for
   12         patient and visitor access to staffing plans and
   13         schedules; providing an effective date.
   14         
   15         WHEREAS, research demonstrates that registered nurses play
   16  a critical role in patient safety and quality of care, and
   17  because of the ever-worsening shortage of nurses, hospitals are
   18  employing multiple strategies to recruit and retain nurses, and
   19         WHEREAS, the implementation of evidence-based nurse
   20  staffing plans to foster safe, high-quality patient care and
   21  increase job satisfaction for nurses is crucial to solving this
   22  urgent public health issue, and
   23         WHEREAS, hospitals and nursing organizations share a mutual
   24  interest in patient safety initiatives that create a healthy
   25  environment for nurses and improve the safe care of patients,
   26  and
   27         WHEREAS, in order to protect patients, support greater
   28  retention of registered nurses, and promote evidence-based nurse
   29  staffing, the Legislature intends to establish a mechanism
   30  whereby direct care nurses and hospital administrative staff
   31  participate in a joint process regarding decisions about nurse
   32  staffing levels, NOW, THEREFORE,
   33         
   34  Be It Enacted by the Legislature of the State of Florida:
   35         
   36         Section 1. Section 395.01922, Florida Statutes, is created
   37  to read:
   38         395.01922Nurse staffing committees.—
   39         (1) As used in this section, the term:
   40         (a) “Acuity” means the level of patient need for nursing
   41  care, as determined by the nursing assessment.
   42         (b) “Nurse staffing committee” means the committee
   43  established by a hospital under this section.
   44         (c) “Nursing personnel” means registered nurses, licensed
   45  practical nurses, certified nursing assistants, and unlicensed
   46  assistive personnel providing direct patient care.
   47         (d) “Nursing-sensitive quality indicators” means indicators
   48  that capture care or the outcomes most affected by nursing care.
   49         (e) “Patient care unit” means any unit or area of the
   50  hospital that provides patient care by registered nurses.
   51         (f) “Skill mix” means the number and relative percentages
   52  of registered nurses, licensed practical nurses, certified
   53  nursing assistants, and unlicensed assistive personnel among the
   54  total number of nursing personnel.
   55         (2) By September 1, 2009, each hospital licensed under this
   56  chapter shall establish a nurse staffing committee, either by
   57  creating a new committee or assigning the functions of a nurse
   58  staffing committee to an existing committee. A majority of the
   59  members of the nurse staffing committee shall be registered
   60  nurses currently providing direct patient care. Other members
   61  shall be determined by the hospital administration.
   62         (3) Primary responsibilities of the nurse staffing
   63  committee shall include:
   64         (a) The development and oversight of an annual patient care
   65  unit and shift-based nurse staffing plan, based on the needs of
   66  patients, to be used as the primary component of the staffing
   67  budget. Factors to be considered in the development of the plan
   68  include, but are not limited to:
   69         1. Census information, including total numbers of patients
   70  in the unit on each shift, and activity in the unit, such as
   71  patient discharges, admissions, and transfers.
   72         2.The acuity level of all patients and the nature of the
   73  care to be delivered on each shift.
   74         3.The skill mix.
   75         4.The level of education, training, and experience of the
   76  nursing personnel providing care.
   77         5. The need for specialized equipment.
   78         6. The architecture and geography of the patient care unit,
   79  including, but not limited to, placement of patient rooms,
   80  treatment areas, nursing stations, medication preparation areas,
   81  and equipment.
   82         7. Staffing guidelines adopted or published by national
   83  professional nursing associations, specialty nursing
   84  organizations, and other health care professional organizations.
   85         8. Hospital finances and resources.
   86         (b) A semiannual review of the staffing plan with regard to
   87  patient needs and evidence-based staffing information, including
   88  the nursing-sensitive quality indicators collected by the
   89  hospital.
   90         (c) A review, assessment, and response to staffing concerns
   91  presented to the committee.
   92         (4) The committee shall produce an annual nurse staffing
   93  plan for the hospital. If the hospital does not adopt the
   94  recommended staffing plan, the chief executive officer of the
   95  hospital shall provide a written explanation of the decision to
   96  the committee.
   97         (5) Each hospital shall post the adopted nurse staffing
   98  plan and staffing schedule for each shift in each patient care
   99  unit. The staffing plan must be posted in an area visible to
  100  employees. Current staffing schedules must be made available to
  101  patients and visitors upon request.
  102         Section 2. This act shall take effect July 1, 2009.