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To enact sections 3727.50 to 3727.57 of the Revised | 1 |
Code regarding hospital staffing guidelines for | 2 |
registered nurses and licensed practical nurses. | 3 |
Section 1. That sections 3727.50, 3727.51, 3727.52, 3727.53, | 4 |
3727.54, 3727.55, 3727.56, and 3727.57 of the Revised Code be | 5 |
enacted to read as follows: | 6 |
Sec. 3727.50. (A) As used in this section and sections | 7 |
3727.51 to 3727.57 of the Revised Code: | 8 |
"Direct patient care" means care provided by a nurse with | 9 |
direct responsibility to carry out medical regimens or nursing | 10 |
care for one or more patients. | 11 |
"Inpatient care unit" means a hospital unit, including an | 12 |
operating room or other inpatient care area, in which nursing care | 13 |
is provided to patients who have been admitted to the hospital. | 14 |
"Nurse" means a person who is licensed to practice as a | 15 |
registered nurse under Chapter 4723. of the Revised Code or, if | 16 |
the hospital employs licensed practical nurses, a person who is | 17 |
licensed to practice as a licensed practical nurse under that | 18 |
chapter. | 19 |
(B) Each hospital shall convene a hospital-wide nursing care | 20 |
committee not later than ninety days after the effective date of | 21 |
this section or, if the hospital is not treating patients on the | 22 |
effective date of this section, ninety days after the hospital | 23 |
begins to treat patients. The hospital's chief nursing officer | 24 |
must be a member and the committee's remaining membership must | 25 |
include, but not be limited to, registered nurses who provide | 26 |
direct patient care in a number sufficient to adequately | 27 |
represent on the committee all types of nursing care services in | 28 |
the hospital. | 29 |
Sec. 3727.51. The chief nursing officer of each hospital | 30 |
shall establish a mechanism for obtaining input from nurses in all | 31 |
inpatient care units who provide direct patient care regarding | 32 |
what the nursing services staffing plan recommendations described | 33 |
in division (B) of section 3727.52 of the Revised Code should | 34 |
include. | 35 |
Sec. 3727.52. A hospital-wide nursing care committee convened | 36 |
pursuant to section 3727.50 of the Revised Code shall do all of | 37 |
the following: | 38 |
(A) If one exists, evaluate the hospital's current nursing | 39 |
services staffing plan; | 40 |
(B) Recommend a nursing services staffing plan that is, at a | 41 |
minimum, consistent with current standards established by private | 42 |
accreditation organizations or governmental entities and addresses | 43 |
all of the following: | 44 |
(1) The selection, implementation, and evaluation of minimum | 45 |
staffing levels for all inpatient care units that ensure that the | 46 |
hospital has a staff of competent nurses with the specialized | 47 |
skills needed to meet patient needs in accordance with | 48 |
evidence-based safe nurse staffing standards; | 49 |
(2) The complexity of complete care, assessment on patient | 50 |
admission, volume of patient admissions, discharges and transfers, | 51 |
evaluation of the progress of a patient's problems, the amount of | 52 |
time needed for patient education, ongoing physical assessments, | 53 |
planning for a patient's discharge, assessment after a change in | 54 |
patient condition, and assessment of the need for patient | 55 |
referrals; | 56 |
(3) Patient acuity and the number of patients for whom care | 57 |
is being provided; | 58 |
(4) The need for ongoing assessments of a unit's patients and | 59 |
its nursing staff levels; | 60 |
(5) The hospital's policy for identifying additional nurses | 61 |
who can provide direct patient care when patients' unexpected | 62 |
needs exceed the planned workload for direct care staff. | 63 |
Sec. 3727.53. Each hospital shall create an evidence-based | 64 |
written nursing care services staffing plan guiding the | 65 |
assignment of nurses hospital-wide. The staffing plan must, at a | 66 |
minimum, reflect current standards established by private | 67 |
accreditation organizations or governmental entities and be | 68 |
implemented not later than ninety days after the hospital-wide | 69 |
nursing care committee is convened pursuant to section 3727.50 of | 70 |
the Revised Code, except that if the hospital's next fiscal year | 71 |
starts not later than one hundred eighty days after the date on | 72 |
which the committee convenes, implementation may be delayed until | 73 |
the first day of that fiscal year. | 74 |
The plan shall be based on multiple nurse and patient | 75 |
considerations that yield minimum staffing levels for inpatient | 76 |
care units that ensure that the hospital has a staff of competent | 77 |
nurses with specialized skills needed to meet patient needs. | 78 |
These considerations shall include both of the following: | 79 |
(A) The recommendations of the hospital-wide nursing care | 80 |
committee made under section 3727.52 of the Revised Code, which | 81 |
shall be given significant consideration; | 82 |
(B) All of the matters listed in divisions (B)(1) to (5) of | 83 |
section 3727.52 of the Revised Code. | 84 |
Sec. 3727.54. At least once a year, the hospital-wide nursing | 85 |
care committee convened pursuant to section 3727.50 of the Revised | 86 |
Code shall do both of the following: | 87 |
(A) Review how the most current nursing services staffing | 88 |
plan does all of the following: | 89 |
(1) Affects inpatient care outcomes; | 90 |
(2) Affects clinical management; | 91 |
(3) Facilitates a delivery system that provides, on a | 92 |
cost-effective basis, quality nursing care consistent with | 93 |
acceptable and prevailing standards of safe nursing care and | 94 |
evidenced-based guidelines established by national nursing | 95 |
organizations. | 96 |
(B) Make recommendations, based on the most recent review | 97 |
conducted under division (A) of this section, regarding how the | 98 |
most current nursing services staffing plan should be revised, if | 99 |
at all. | 100 |
Sec. 3727.55. To provide staffing flexibility to meet patient | 101 |
needs, every hospital shall identify a model for adjusting the | 102 |
staffing plan created under section 3727.53 of the Revised Code | 103 |
for each inpatient care unit. | 104 |
Sec. 3727.56. A copy of the nursing care services staffing | 105 |
plan created under section 3727.53 of the Revised Code, and | 106 |
subsequent changes to it, shall be provided, free of charge, to | 107 |
the hospital's nursing staff and, at a cost not to exceed the cost | 108 |
for copying the plan, to any other peson who requests it. | 109 |
Sec. 3727.57. Nothing in sections 3727.50 to 3727.56 of the | 110 |
Revised Code shall be construed to limit, alter, or modify any of | 111 |
the terms, conditions, or provisions of a collective bargaining | 112 |
agreement entered into by a hospital. | 113 |