HB 463

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; requiring
6	committees to produce annual hospital nurse staffing
7	plans; requiring the chief executive officer to provide a
8	written explanation for refusal to adopt a proposed
9	staffing plan; requiring the hospital to post the adopted
10	nurse staffing plan and nurse staffing schedule in patient
11	care units; providing for patient and visitor access to
12	staffing plans and schedules; providing an effective date.
13
14	WHEREAS, research demonstrates that registered nurses play
15	a critical role in patient safety and quality of care, and
16	because of the ever-worsening shortage of nurses hospitals are
17	employing multiple strategies to recruit and retain nurses, and
18	WHEREAS, the implementation of evidence-based nurse
19	staffing plans to foster safe, high-quality patient care and
20	increase job satisfaction for nurses is crucial to solving this
21	urgent public health issue, and
22	WHEREAS, hospitals and nursing organizations share a mutual
23	interest in patient safety initiatives that create a healthy
24	environment for nurses and improve the safe care of patients,
25	and
26	WHEREAS, in order to protect patients, support greater
27	retention of registered nurses, and promote evidence-based nurse
28	staffing, the Legislature intends to establish a mechanism
29	whereby direct care nurses and hospital administrative staff
30	participate in a joint process regarding decisions about nurse
31	staffing levels, NOW, THEREFORE,
32
33	Be It Enacted by the Legislature of the State of Florida:
34
35	Section 1.  Section 395.01922, Florida Statutes, is created
36	to read:
37	395.01922  Nurse staffing committees.--
38	(1)  As used in this section, the term:
39	(a)  "Acuity" means the level of patient need for nursing
40	care, as determined by the nursing assessment.
41	(b)  "Nurse staffing committee" means the committee
42	established by a hospital under this section.
43	(c)  "Nursing personnel" means registered nurses, licensed
44	practical nurses, certified nursing assistants, and unlicensed
45	assistive personnel providing direct patient care.
46	(d)  "Nursing-sensitive quality indicators" means
47	indicators that capture care or the outcomes most affected by
48	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
56	this chapter shall establish a nurse staffing committee, either
57	by creating a new committee or assigning the functions of a
58	nurse staffing committee to an existing committee. A majority of
59	the 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
65	care unit and shift-based nurse staffing plan, based on the
66	needs of patients, to be used as the primary component of the
67	staffing budget. Factors to be considered in the development of
68	the plan 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
79	unit, 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
87	to patient needs and evidence-based staffing information,
88	including the nursing-sensitive quality indicators collected by
89	the hospital.
90	(c)  A review, assessment, and response to staffing
91	concerns 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.

CODING: Words stricken are deletions; words underlined are additions.