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staffing standards. 10. Vermont Law Definition Current status Main characteristics VT Statute Title 18 § 1854 • Public access to information • Enacted Hospitals make public the maximum patient census and the number of RNs, licensed practical nurses, and licensed nursing assistants providing direct patient care by unit and shift using fulltime equivalents (every 8 or 12 hours worked by an RN, licensed practical nurse, or licensed nursing assistant as one full-time equivalent). Facilities report results, posted prominently and readily accessible to patients and visitors once each day for the previous 7 days. 11. Washington Law Definition Current status Main characteristics RCW § 70.41.420 n/a • Enacted • Hospitals establish either a new nurse staffing committee or assign functions to an existing committee. At least half the members are RNs currently providing direct patient care, up to half selected by the hospital administration aligned with existing collective-bargaining agreements. Lacking a collective-bargaining agreement, peers select RN members. Participation is scheduled, and work time compensated, replacing all other work duties during meetings. • Responsibilities include developing and overseeing annual patient care and a shift-based nurse staffing plan, based on patients’ needs. The Plan includes patient census by shift and activity (discharges, admissions, and transfers); level of intensity of patients; nature of care delivered; skill mix; level of experience and specialty certification or training of nurses; needs for specialized or intensive equipment; architecture and geography of the patient-care unit (patient room placement, treatment areas, nursing stations, medication preparation areas, and equipment); and staffing guidelines from national nursing professional associations, specialty nursing organizations, and other health-professional organizations; semiannual review of nursing-sensitive quality indicators and staffing concerns. • The committee considers hospital finances and resources. • Hospitals post the plan in a public area in each patient-care unit, including the nurse-staffing schedule for that shift. • Hospitals may not retaliate against or intimate employees for performing on the committee or employees, patients, or others who notify the committee or hospital administration of concerns. • Critical-access hospitals may develop flexible approaches to accomplish the requirements, including holding meetings by telephone or email. ŽnnĞĐƟĐƵƚ͗ On the basis of Public Act 08-79, An Act Concerning Hospital ^ƚĂĸnŐ͕ ŽnnĞcƟcƵƚ law requires that every hospital organize a ƐƚĂĸnŐ cŽmmŝƩĞĞ͘ Each facility must make ƌĞŐƵůĂƟŽnƐ that specify use of temporary nurses, and the law suggests a minimum nursing skill-mix ƌĂƟŽ [15]. Illinois: On the basis of Public Act 095-0401, Illinois law requires that every hospital organize a ƐƚĂĸnŐ cŽmmŝƩĞĞ that includes a majority of members who are direct-care nurses. Also, the hospital must administrate general mĂƩĞƌƐ about nurse ƐƚĂĸnŐ such as records, ƌĞƉƌĞƐĞnƚĂƟvĞnĞƐƐ͕ and quality management [16]. Nevada: On the basis of the WĂƟĞnƚ WƌŽƚĞcƟŽn and Safe ^ƚĂĸnŐ Bill (SB 362), Nevada law requires that every hospital organize a ƐƚĂĸnŐ cŽmmŝƩĞĞ and establish standards for highquality ƉĂƟĞnƚ care. If hospitals do not develop a ƐƚĂĸnŐ plan, Nevada law suggests they will be ŝnvĞƐƟŐĂƚĞĚ and assessed ƉĞnĂůƟĞƐ and ĮnĞƐ [17]. Oregon: On the basis of the Nurse WƌĂcƟcĞ Act (Oregon Revised Statutes, Chapter 678.010-678.445), Oregon law requires that every hospital make a hospital nƵƌƐĞͲƐƚĂĸnŐ plan that includes direct-care nurses [18]. Rhode Island: On the basis of Rhode Island Law § 23-17.17-8, hospitals in Rhode Island must submit a nƵƌƐĞͲƐƚĂĸnŐ plan to present the average nursing skill mix for each unit and each ƐŚŝŌ [19]. Texas: On the basis of the Health and Safety Code Chapter 257, Nurse ^ƚĂĸnŐ͕ Texas law requires that each medical center organizes a cŽmmŝƩĞĞ on nurse ƐƚĂĸnŐ of which 60% must be nurses who provide direct care to ƉĂƟĞnƚƐ for more than 50% of their duty hours. The cŽmmŝƩĞĞ has to develop the nƵƌƐĞͲ ƐƚĂĸnŐ guidelines, ĞĸcŝĞnƚ ŽƉĞƌĂƟŽn of nurse ƐƚĂĸnŐ͕ and an ĞvĂůƵĂƟŽn plan [20]. Vermont: On the basis of VT Statute Title 18 § 1854, medical centers in Vermont must provide public nŽƟcĞ of ŝnĨŽƌmĂƟŽn on nurse ƐƚĂĸnŐ [21]. Washington: On the basis of RCW § 70.41.420, Washington law requires that each medical center organize a ƐƚĂĸnŐ cŽmmŝƩĞĞ 50% of whom must be nurses who provide direct care to ƉĂƟĞnƚƐ͘ The cŽmmŝƩĞĞ must develop plans about an appropriate number of nurses for each unit and ƐŚŝŌ and provide public nŽƟcĞ of ŝnĨŽƌmĂƟŽn about nurse ƐƚĂĸnŐ [22]. Discussion Legal standards for ŽƉƟmĂů nurse ƐƚĂĸnŐ worldwide are no doubt necessary. This ŝnƚĞŐƌĂƟvĞ review discerned that nursing law exists in 11 states. Three states (California, New York, and MĂƐƐĂcŚƵƐĞƩƐ) suggested nƵƌƐĞͲƚŽͲƉĂƟĞnƚ ƌĂƟŽƐ with cŽnƐŝĚĞƌĂƟŽn of ƉĂƟĞnƚƐ͛ severity of need. ^ƉĞcŝĮcĂůůy͕ California enacted a law that requires minimum nurse ƐƚĂĸnŐ͘ The tenet that every intensive care unit has to arrange nƵƌƐĞͲƚŽͲ Health Systems and Policy Research ISSN 2254-9137 Vol.5 No.1:67 2018 © Under License of ƌĞĂƟvĞ Commons
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