Ratio question

[FLOBRN]

Here in Florida we are getting ready to submit mandatory ratio legistlation. My question is what do you do when though you have been origionally staffed to ratio, a sudden change in pt acuity or sudden pt influx now makes you out of compliance. Is there a certain number of hours admin has to get you back into compliance or how does that work?

Thanks

PS As you might guess, admin is against ratio's

[herring_RN, ASN, BSN]

i have heard that the proposed legislation for florida improves on the california law.

our california regulations include as the last paragraph:

...the hospital shall plan for routine fluctuations in patient census. if a healthcare emergency causes a change in the number of patients on a unit, the hospital must demonstrate that prompt efforts were made to maintain required staffing levels. a healthcare emergency is defined for this purpose as an unpredictable or unavoidable occurrence at unscheduled or unpredictable intervals relating to healthcare delivery requiring immediate medical interventions and care....

http://www.cdph.ca.gov/services/dpopp/regs/documents/r-37-01_regulation_text.pdf

[FLOBRN]

Thanks for the reply : ) I work L/D and am a bit confused by that section of these regulations : 1:4 mother baby couplets (which is actually 8 patients) but 1:6 if Moms only. Wonder why unless they are thinking fresh c/s.

[herring_RN, ASN, BSN]

The nursery is staffed with an RN and an LVN. A third "baby nurse" is assigned to the nursery but cares for the babies when they are with the mothers and transports babies at mothers request. Kind of old fashioned but one hospital still does it that way.

I only hear this from friends because I'm not a maternal/child nurse.

As I typed before i think your ratios will improve on what we have.

(3) The licensed nurse-to-patient ratio in a labor and delivery suite of the perinatal service shall be 1:2 or fewer active labor patients at all times.

When a licensed nurse is caring for antepartum patients who are not in active labor, the licensed nurse-to-patient ratio shall be 1:4 or fewer at all times.

(4) The licensed nurse-to-patient ratio in a postpartum area of the perinatal service shall be 1:4 mother-baby couplets or fewer at all times.

In the event of multiple births, the total number of mothers plus infants assigned to a single licensed nurse shall never exceed eight. For postpartum areas in which the licensed nurse’s assignment consists of mothers only, the licensed nurse-to-patient ratio shall be 1:6 or fewer at all times.

(5) The licensed nurse-to-patient ratio in a combined Labor/Delivery/Postpartum area of the perinatal service shall be 1:3 or fewer at all times the licensed nurse is caring for a patient combination of one woman in active labor and a postpartum mother and infant

The licensed nurse-to-patient ratio for nurses caring for women in active labor only, antepartum patients who are not in active labor only, postpartum women only, or mother-baby couplets only, shall be the same ratios as stated in subsections (3) and (4) above for those categories of patients.

(6) The licensed nurse-to-patient ratio in a pediatric service unit shall be 1:4 or fewer at all times

http://www.cdph.ca.gov/services/DPOPP/regs/Documents/R-37-01_Regulation_Text.pdf

[FLOBRN]

I'll let you know as tomorrow we are off to Tallahassee. I will probably get my first look at the legislation then.