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