Synopsis As Introduced Creates the Safe Patient Limits Act. Provides the maximum number of patients that may be assigned to a registered nurse in specified situations. Provides that nothing shall preclude a facility from assigning fewer patients to a registered nurse than the limits provided in Act. Provides that nothing in the Act precludes the use of patient acuity systems consistent with the Nurse Staffing by Patient Acuity Act; however, the maximum patient assignments in the Act may not be exceeded, regardless of the use and application of any patient acuity system. Provides that the Department of Public Health shall adopt rules governing the implementation and operation of the Act. Provides that all facilities shall adopt written policies and procedures for training and orientation of nursing staff and that no registered nurse shall be assigned to a nursing unit or clinical area unless that nurse has, among other things, demonstrated competence in providing care in that area. Provides that the written policies and procedures for the training and orientation of nursing staff shall require that all temporary personnel receive the same amount and type of training and orientation that is required for permanent staff. Provides that the Act's provisions are severable.
Replaces everything after the enacting clause with the provisions of the introduced bill with the following changes. Defines "registered nurse", "direct care registered professional nurse", and "rapid response team". Excludes specified facilities from the definition of "facility". Adds LTAC hospitals and ambulatory surgical treatment centers to the definition of "facility". Makes changes to the definition of "nursing care". Provides that in all units with critical care or intensive care patients, the maximum patient assignment of critical care patients to a registered nurse is 2. Provides that at least one direct care registered professional nurse shall be assigned to triage patients, shall be immediately available at all times to triage patients when they arrive in the emergency department, and shall perform triage functions only. Provides that in all units with acute rehabilitation patients the maximum patient assignment of acute rehabilitation patients to a registered nurse is 4 (rather than 3). Provides that in all units with conscious sedation patients, the maximum patient assignment of conscious sedation patients to a registered nurse is one. Provides that in all units with pediatric patients, the maximum patient assignment of pediatric patients to a registered nurse is 3 (instead of 4) and in all units with observational patients, the maximum patient assignment of observational patients to a registered nurse is 3 (instead of 4). Provides that a rapid response team nurse shall not be given direct care patient assignments while assigned as a nurse responsible for responding to a rapid response team request. Provides specified requirements for the Act's implementation by a facility. Provides that a facility shall plan for routine fluctuations in its patient census. Provides that if a health care emergency causes a change in the number of patients in a clinical care unit or patient care area, a facility must be able to demonstrate that immediate and diligent efforts were made to maintain required staffing levels. Establishes recordkeeping requirements. Provides that any method, software, or tool used to create or evaluate a staffing plan adopted by a facility shall be established in coordination with direct care registered professional nurses and shall be transparent in all respects. Requires the Department of Public Health to establish procedures to ensure that the documentation submitted is available for public inspection in its entirety. Provides specified nurse rights and protections. Amends the Hospital Licensing Act. Provides that a hospital shall not mandate that a registered professional nurse delegate nursing interventions. Amends the Nurse Practice Act. Provides that the exercise of professional judgment by a direct care registered professional nurse in the performance of his or her scope of practice shall be provided in the exclusive interests of the patient. Makes other changes.
Home Rule Note, House Committee Amendment No. 2 (Dept. of Commerce & Economic Opportunity)
This bill does not pre-empt home rule authority.
State Mandates Fiscal Note, House Committee Amendment No. 2 (Dept. of Commerce & Economic Opportunity)
This bill does not create a State mandate.
Fiscal Note, House Committee Amendment No. 2 (Dept. of Public Health)
This bill would not pose any fiscal impact to the Department of Public Health.