Safe staffing legislation--win-win for Ohio and others.

Ohio's governor signed into law on June 12th safe nurse staffing legislation. Approaches to staffing legislation have varied between states. Ohio joins the ranks of five states requiring staffing plans: (IL, OR, RI, TX, WA).

Provisions of Ohio's law include:

* Each hospital shall convene a hospital-wide nursing care committee not later than ninety days after the effective date.

(1) The hospital's chief nursing officer shall be included as a member of the committee.

(2) At least fifty per cent of the committee's membership shall consist of RNs who provide direct patient care in the hospital.

(3) The number of RNs included as members of the committee shall be sufficient to provide adequate representation of all types of nursing care services provided in the hospital.

* The hospital's chief nursing officer shall establish a mechanism for obtaining input from nurses in all inpatient care units who provide direct patient care regarding the nursing services staffing plan recommendations.

* A hospital-wide nursing care committee shall do the following:

(1) Evaluate the hospital's current nursing services staffing plan, if one exists;

(2) Recommend a nursing services staffing plan that is, at a minimum, consistent with current standards established by private accreditation organizations or governmental entities and addresses all of the following:

(A) The selection, implementation, and evaluation of minimum staffing levels for all inpatient care units that ensure that the hospital has a staff of competent nurses with the specialized skills needed to meet patient needs in accordance with evidence-based safe nurse staffing standards;

(B) The complexity of complete care, assessment on patient admission, volume of patient admissions, discharges and transfers, evaluation of the progress of a patient's problems, the amount of time needed for patient education, ongoing physical assessments, planning for a patient's discharge, assessment after a change in patient condition, and assessment of the need for patient referrals;

(C) Patient acuity and the number of patients for whom care is being provided;

(D) The need for ongoing assessments of a unit's patients and its nursing staff levels;

(E) The hospital's policy for identifying additional nurses who can provide direct patient care when patients' unexpected needs exceed the planned workload for direct care staff.

(F) The written staffing plan is evidence-based, guiding the assignment of nurses hospital-wide. The staffing plan shall be implemented not later than ninety days after the hospital-wide nursing care committee is convened, unless the hospital's fiscal year starts later than one hundred eighty days after the date on which the committee convenes; then implementation may be delayed until the first day of that fiscal year.

* At least once a year, the hospital-wide nursing care committee will be convened to:

(1) Review how the most current nursing services staffing plan:

(A) Affects inpatient care outcomes;

(B) Affects clinical management;

(C) Facilitates a delivery system that provides, on a cost-effective basis, quality nursing care consistent with acceptable and prevailing standards of safe nursing care and evidenced-based guidelines established by national nursing organizations.

(2) Make recommendations, based on the most recent review conducted under division

(A) of this section, regarding how the most current nursing services staffing plan should be revised, if at all.

* The plan will provide staffing flexibility to meet patient needs, with every hospital identifying a model for adjusting as needed.

* A hospital shall provide copies of its nursing services staffing plan:

1) Free of charge, a copy of the staffing plan and subsequent changes to the plan shall be provided to each member of the hospital's nursing staff

(2) For a fee not to exceed actual copying costs, a copy of the staffing plan shall be provided to any person who requests it.

(3) In a conspicuous location in the hospital, a notice shall be posted informing the public of the availability of the staffing plan. The notice shall specify the appropriate person, office, or department to be contacted to review or obtain a copy of the staffing plan.

Congratulations to Ohio nurses!

Connecticut has also succeeded in securing safe nurse staffing legislation for its patients and nurses through staffing plans with the Governor's signature on May 27, 2008.

The results are now seven states (CT, IL, OH, OR, RI, TX and WA) which require hospital-wide staffing plans, created by a committee with membership comprised of at least 50% direct care.

Janet Haebler MSN RN, Associate Director State Government Affairs