Nurse Staffing Standard Act

  1. Hi. I am new to this site so I hope I'm doing it correctly. I am in my second yr. I have one more semester & will graduate in May with my RN. I came across this pretty neat site while trying access some information regarding the bill that's trying to get passed here in Illinois in January 2007. It's called the Nurse Staffing Standard Act. It was passed in California in 2004 but denied in Massachusetts from what I am hearing. I just can't seem to find more info. Does anyone know about this bill & its effects? I hope I can figure out how to read any replies
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    Joined: Dec '06; Posts: 5


  3. by   Daytonite
    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: - lists the official section where this california law is filed - a thread on allnurses where this law was discussed. there are also some weblinks to articles about it. some are still active. - 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:

    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.
    (c) "critical care unit" as used in this section means a unit that
    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
    (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
    (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.