Florida Senate - 2015                                    SB 1342
       By Senator Braynon
       36-00559-15                                           20151342__
    1                        A bill to be entitled                      
    2         An act relating to nurse staffing levels; creating s.
    3         395.01922, F.S.; providing definitions; establishing a
    4         nurse staffing committee in each hospital; providing
    5         membership and duties; requiring the hospital to post
    6         and publicize the nurse staffing plan and schedule;
    7         providing an effective date.
    9         WHEREAS, registered nurses play a critical role in patient
   10  safety and quality of care and the ever-worsening shortage of
   11  nurses available to provide care in acute care hospitals has
   12  necessitated multiple strategies to generate more nurses and
   13  improve the recruitment and retention of nurses in hospitals,
   14  and
   15         WHEREAS, evidence-based nurse staffing can improve the
   16  quality of patient care and improve nurse satisfaction in the
   17  work environment, and hospital administrators and nursing
   18  organizations recognize a mutual interest in promoting
   19  initiatives that create a healthy environment for nurses and
   20  safe care for patients, and
   21         WHEREAS, to protect patients, support greater retention of
   22  registered nurses, and promote evidence-based nurse staffing
   23  initiatives, the Legislature intends to establish a mechanism
   24  whereby direct patient care nurses and hospital management shall
   25  participate in a joint process regarding decisions about nurse
   26  staffing levels, NOW, THEREFORE,
   28  Be It Enacted by the Legislature of the State of Florida:
   30         Section 1. Section 395.01922, Florida Statutes, is created
   31  to read:
   32         395.01922 Nurse Staffing levels.—
   33         (1) DEFINITIONS.—As used in this section, the term:
   34         (a) “Acuity” means the level of patient need for nursing
   35  care, as determined by the nursing assessment.
   36         (b) “Employee injury or illness” means an unexpected
   37  physical or psychological injury or illness sustained by nursing
   38  staff in the performance of their nursing duties.
   39         (c) “Nursing personnel” means a registered nurse, a
   40  licensed practical nurse, a certified nursing assistant, or
   41  unlicensed assistive personnel who provide direct patient care.
   42         (d) “Patient care unit” means a unit or area of the
   43  hospital where patient care is provided by registered nurses.
   44         (e) “Sentinel event” means an unexpected patient death or
   45  injury as defined by the hospital.
   46         (f) “Skill mix” means the number and relative percentages
   47  of registered nurses, licensed practical nurses, certified
   48  nursing assistants, and unlicensed assistive personnel who
   49  provide direct patient care among the total number of nursing
   50  personnel.
   51         (2) NURSE STAFFING COMMITTEE.—
   52         (a) By September 1, 2015, each hospital shall establish a
   53  nurse staffing committee, either by creating a new committee or
   54  assigning the functions of a nurse staffing committee to an
   55  existing committee. At least one-half of the members of the
   56  nurse staffing committee shall be registered nurses currently
   57  providing direct patient care and up to one-half of the members
   58  shall be determined by the hospital administration.
   59         (b) The nurse staffing committee shall:
   60         1. Develop and oversee an annual patient care unit and
   61  shift-based nurse staffing plan, based on the needs of patients,
   62  to be used as the primary component of the staffing budget.
   63  Factors to be considered in the development of the plan shall
   64  include, but are not limited to:
   65         a. Census data, including total number of patients on the
   66  unit on each shift and activity such as patient discharges,
   67  admissions, and transfers.
   68         b. Level of acuity of each patient and nature of the care
   69  to be delivered on each shift.
   70         c. Skill mix.
   71         d. Level of education, training, and experience of nursing
   72  personnel providing care.
   73         e. The need for specialized or intensive equipment,
   74  including protective equipment.
   75         f. The architecture and geography of the patient care unit,
   76  including, but not limited to, placement of patient rooms,
   77  treatment areas, quarantine areas, nursing stations, medication
   78  preparation areas, and equipment, including protective
   79  equipment.
   80         g. Staffing guidelines adopted or published by national
   81  nursing professional associations, specialty nursing
   82  organizations, and other health professional organizations.
   83         h. Hospital finances and resources.
   84         2. Review and revise the nurse staffing plan semiannually,
   85  based on the needs of patients and evidence-based staffing
   86  information, including information relating to the quality of
   87  nursing care collected by the hospital.
   88         3. Review, assess, and respond to staffing or other
   89  concerns.
   90         4. Review data relating to sentinel events, employee
   91  injuries, and employee illnesses and evaluate whether the nurse
   92  staffing plan was a contributing factor. The committee shall
   93  revise the nurse staffing plan if staffing was a contributing
   94  factor to a sentinel event.
   95         (c) Each hospital shall post, in an employee area on each
   96  patient care unit, the nurse staffing plan and the nurse
   97  staffing schedule for the shift on that unit and the relevant
   98  clinical staffing for that shift.
   99         (d) Each hospital shall publish the nurse staffing plan on
  100  its website. Patients and visitors shall be provided with a
  101  print version of the nurse staffing plan upon request. The
  102  hospital shall provide the following information to patients and
  103  visitors:
  104         1. Anticipated staffing mix for the requested unit,
  105  including the number of registered nurses, licensed practical
  106  nurses, nursing assistants, unlicensed personnel who provide
  107  direct patient care, and clerical support staff.
  108         2. Anticipated number of registered nurses providing care
  109  in the requested unit for the requested period.
  110         Section 2. This act shall take effect July 1, 2015.