New bill for safe nursing standards

Nurses Activism

Published

Has anyone seen this new bill summary? I think we need to all write to our representatives and support it. If anyone is interested, I have a sample letter that I would be glad to forward on to you to send. We need to fight for the safer ratios in hospitals and long term care facilities. We have a voice in what we are subjected to. I just thought this was a great start.

The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2004 (H.R. 4316)

Introduced by Rep. Jan Schakowsky (D-IL)

The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2004 establishes minimum registered nurse-to-patient staffing ratios to improve patient safety and quality of care and to address the nursing shortage that has left our nation's hospitals critically understaffed.

Bill Summary

By January 2007--two years later for rural hospitals--hospitals will be expected to develop and implement nurse staffing plans that meet newly-established minimum direct care registered nurse-to-patient ratios, adjust staffing levels based on acuity of patients and other factors, and ensure quality care and patient safety.

Minimum direct care registered nurse-to-patient ratios: A hospital would be required during each shift, except during a declared emergency, to assign a direct care registered nurse to no more than the following number of patients in designated units:

  • 1 patient in an operating room and trauma emergency unit
  • 2 patients in all critical care units, intensive care, labor and delivery and postanesthesia units
  • 3 patients in antepartum, emergency, pediatrics, step-down and telemetry units
  • 4 patients in intermediate care nursery, medical/surgical and acute care psychiatric care units
  • 5 patients in rehabilitation units
  • 6 patients in postpartum (3 couplets) and well baby nursery units

Based on the outcome of a required study, staffing requirements will be established for licensed practical nurses and will be required to be implemented in all hospitals by January 2007.

Staffing Plans Developed Together with Direct Care Nurses: Hospitals will be required to develop staffing plans no later than January 1, 2006 and must involve direct care nurses and other health care workers or their representatives in the development and the annual re-evaluation of those plans.

The plans must identify and employ an approved acuity system that will establish guidelines by which the hospital must increase staffing above the required minimums based on patient need. The plans must also factor in an appropriate skill mix of other health care workers to ensure that staffing levels account for patient care needs that do not require a direct care registered nurse.

Beginning in 2007, plans must at least comply with minimum ratio standards, but may need to meet higher standards based on hospital specifics.

Enforcement: Uniform notices stating the requirements of this bill including the actual direct care nurse-to-patient ratios for each unit must be posted in a visible, conspicuous and accessible location for both patients and direct care staff.

Hospitals that fail to comply with the nurse staffing plan requirements could face a range of corrective actions, including civil monetary penalties and loss of funds.

Whistleblower Protection: This bill would provide whistleblower protection for nurses by securing a nurse's right and obligation to refuse assignment if doing so threatens the safety and health of a patient by violating the minimum ratios as set forth in this bill or if a nurse is not professionally prepared to fulfill an assignment. The bill also provides protections to any hospital employee who reports a violation of this Act.

Reimbursement: The bill allows for hospitals to receive additional Medicare reimbursement related to costs incurred related to compliance with this bill. Such reimbursement will be based on recommendations by Medicare Payment Advisory Commission (MedPAC).

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I saw the bill tonight at

http://www.dixonconsulting.net/SafeStaffing/federal.htm

This bill states it will go into effect "as soon as practicable, as determined by the Secretary, but not later than two years from the date of this title (May 4, 2004)..."

Look at the area above that paragraph and see the exceptions.."not later than 1 year from the date of this title."

The title specifically states which areas must comply by May 4, 2005.

Now, the kicker is the Secretary...we need to determine who that person is and contact that person's office if on May 4th, assigned to a monitored unit for example, we are given an assignment of 6 or 7 patients (5 who are being monitored).

Nurses! May 4th is Liberation Day!

Has anyone seen this new bill summary? I think we need to all write to our representatives and support it. If anyone is interested, I have a sample letter that I would be glad to forward on to you to send. We need to fight for the safer ratios in hospitals and long term care facilities. We have a voice in what we are subjected to. I just thought this was a great start.

The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2004 (H.R. 4316)

Introduced by Rep. Jan Schakowsky (D-IL)

The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2004 establishes minimum registered nurse-to-patient staffing ratios to improve patient safety and quality of care and to address the nursing shortage that has left our nation's hospitals critically understaffed.

Bill Summary

By January 2007--two years later for rural hospitals--hospitals will be expected to develop and implement nurse staffing plans that meet newly-established minimum direct care registered nurse-to-patient ratios, adjust staffing levels based on acuity of patients and other factors, and ensure quality care and patient safety.

Minimum direct care registered nurse-to-patient ratios: A hospital would be required during each shift, except during a declared emergency, to assign a direct care registered nurse to no more than the following number of patients in designated units:

  • 1 patient in an operating room and trauma emergency unit
  • 2 patients in all critical care units, intensive care, labor and delivery and postanesthesia units
  • 3 patients in antepartum, emergency, pediatrics, step-down and telemetry units
  • 4 patients in intermediate care nursery, medical/surgical and acute care psychiatric care units
  • 5 patients in rehabilitation units
  • 6 patients in postpartum (3 couplets) and well baby nursery units

Based on the outcome of a required study, staffing requirements will be established for licensed practical nurses and will be required to be implemented in all hospitals by January 2007.

Staffing Plans Developed Together with Direct Care Nurses: Hospitals will be required to develop staffing plans no later than January 1, 2006 and must involve direct care nurses and other health care workers or their representatives in the development and the annual re-evaluation of those plans.

The plans must identify and employ an approved acuity system that will establish guidelines by which the hospital must increase staffing above the required minimums based on patient need. The plans must also factor in an appropriate skill mix of other health care workers to ensure that staffing levels account for patient care needs that do not require a direct care registered nurse.

Beginning in 2007, plans must at least comply with minimum ratio standards, but may need to meet higher standards based on hospital specifics.

Enforcement: Uniform notices stating the requirements of this bill including the actual direct care nurse-to-patient ratios for each unit must be posted in a visible, conspicuous and accessible location for both patients and direct care staff.

Hospitals that fail to comply with the nurse staffing plan requirements could face a range of corrective actions, including civil monetary penalties and loss of funds.

Whistleblower Protection: This bill would provide whistleblower protection for nurses by securing a nurse's right and obligation to refuse assignment if doing so threatens the safety and health of a patient by violating the minimum ratios as set forth in this bill or if a nurse is not professionally prepared to fulfill an assignment. The bill also provides protections to any hospital employee who reports a violation of this Act.

Reimbursement: The bill allows for hospitals to receive additional Medicare reimbursement related to costs incurred related to compliance with this bill. Such reimbursement will be based on recommendations by Medicare Payment Advisory Commission (MedPAC).

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Don't all states?

Although this is a great start...what about LTC facilities? I don't see any mention in this bill about safe staffing for those patients.
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