Nurse Staffing Standard Act

Daytonite, BSN, RN · Dec 17, 2006

hi, faith2day!

hi! what a subject you have chosen! i recently did a paper on no lifting laws. i found that when you are searching there is a difference between law (already passed) and legislation (proposed laws) when you are searching. often there are two different websites for each state for each of these categories. i found what you are looking for and it is posted below. in finding the actual law for you i found a lot of articles by doing a search for "california nurse patient staffing ratio law". you might also want to look at the website for the american association of registered nurses who seem to be very much for these laws. any of the hospital associations or nursing associations should also have information about them. guess who's on which side? what i found in doing my research on no lifting laws was that by accessing the information on the proposed bills, i was often able to find synopses of the testimony that was given at the various hearings before the state legislators as the bills were being researched and got a lot of information as well as names of people and their sponsoring associations to use as my arguments as to who was for and against the laws that way. if i wasn't able to find any further information i used these documents from the legislative sites as my references and my instructor, who is also a licensed lawyer, accepted them. good luck! here's some information for you:

http://ahlaweb.healthlawyers.org/hlw/issues/030509/030509_a_art_01_boyer.cfm - lists the official section where this california law is filed

https://allnurses.com/forums/f195/too-few-nurses-california-meet-new-hospital-staffing-law-61660.html - a thread on allnurses where this law was discussed. there are also some weblinks to articles about it. some are still active.

http://www.applications.dhs.ca.gov/pressreleases/store/pressreleases/04-70.html - seems to have been some problems with implementing this law as you will see by reading this webpage from the california department of health services from 2004. i know of one hospital down the road from me, santa teresita, which had to close is acute hospital section due to not being able to meet this new staffing ration requirement.

here is the law (section 1276.4 of california health and safety code) retrieved from this website: http://www.leginfo.ca.gov/cgi-bin/waisgate?waisdocid=37101118943+0+0+0&waisaction=retrieve

1276.4. (a) by january 1, 2002, the state department of health

services shall adopt regulations that establish minimum, specific,

and numerical licensed nurse-to-patient ratios by licensed nurse

classification and by hospital unit for all health facilities

licensed pursuant to subdivision (a), (b), or (f) of section 1250.

the department shall adopt these regulations in accordance with the

department's licensing and certification regulations as stated in

sections 70053.2, 70215, and 70217 of title 22 of the california code

of regulations, and the professional and vocational regulations in

section 1443.5 of title 16 of the california code of regulations.

the department shall review these regulations five years after

adoption and shall report to the legislature regarding any proposed

changes. flexibility shall be considered by the department for rural

general acute care hospitals in response to their special needs. as

used in this subdivision, "hospital unit" means a critical care

unit, burn unit, labor and delivery room, postanesthesia service

area, emergency department, operating room, pediatric unit,

step-down/intermediate care unit, specialty care unit, telemetry

unit, general medical care unit, subacute care unit, and transitional

inpatient care unit. the regulation addressing the emergency

department shall distinguish between regularly scheduled core staff

licensed nurses and additional licensed nurses required to care for

critical care patients in the emergency department.

(b) these ratios shall constitute the minimum number of registered

and licensed nurses that shall be allocated. additional staff shall

be assigned in accordance with a documented patient classification

system for determining nursing care requirements, including the

severity of the illness, the need for specialized equipment and

technology, the complexity of clinical judgment needed to design,

implement, and evaluate the patient care plan and the ability for

self-care, and the licensure of the personnel required for care.

is established to safeguard and protect patients whose severity of

medical conditions requires continuous monitoring, and complex

intervention by licensed nurses.

(d) all health facilities licensed under subdivision (a), (b), or

(f) of section 1250 shall adopt written policies and procedures for

training and orientation of nursing staff.

(e) no registered nurse shall be assigned to a nursing unit or

clinical area unless that nurse has first received orientation in

that clinical area sufficient to provide competent care to patients

in that area, and has demonstrated current competence in providing

care in that area.

(f) the written policies and procedures for orientation of nursing

staff shall require that all temporary personnel shall receive

orientation and be subject to competency validation consistent with

sections 70016.1 and 70214 of title 22 of the california code of

regulations.

(g) requests for waivers to this section that do not jeopardize

the health, safety, and well-being of patients affected and that are

needed for increased operational efficiency may be granted by the

state department to rural general acute care hospitals meeting the

criteria set forth in section 70059.1 of title 22 of the california

code of regulations.

(h) in case of conflict between this section and any provision or

regulation defining the scope of nursing practice, the scope of

practice provisions shall control.

(i) the regulations adopted by the department shall augment and

not replace existing nurse-to-patient ratios that exist in regulation

or law for the intensive care units, the neonatal intensive care

units, or the operating room.

(j) the regulations adopted by the department shall not replace

existing licensed staff-to-patient ratios for hospitals operated by

the state department of mental health.

(k) the regulations adopted by the department for health

facilities licensed under subdivision (b) of section 1250 that are

not operated by the state department of mental health shall take into

account the special needs of the patients served in the psychiatric

units.

(l) the department may take into consideration the unique nature

of the university of california teaching hospitals as educational

institutions when establishing licensed nurse-to-patient ratios. the

department shall coordinate with the board of registered nursing to

ensure that staffing ratios are consistent with the board of

registered nursing approved nursing education requirements. this

includes nursing clinical experience incidental to a work-study

program rendered in a university of california clinical facility

approved by the board of registered nursing provided there will be

sufficient direct care registered nurse preceptors available to

ensure safe patient care.