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: 38 395.01922 Nurse 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.