THE NURSE STAFFING IMPROVEMENT ACT OF 2021
A 21st-Century Solution For Nurse Staffing
No one staffing model is appropriate for all settings of care or situations. Our patients’ needs change continually. Quality care requires nurse-driven, flexible staffing plans. The Nurse Staffing Improvement Act of 2021 will help drive solutions to staffing issues facing Illinois hospitals.
THE NURSE STAFFING IMPROVEMENT ACT OF 2021 WILL:
- STRENGTHEN THE VOICE OF THE DIRECT-CARE REGISTERED NURSE
- STRENGTHEN THE ROLE OF THE NURSING CARE COMMITTEE
- HOLD HOSPITALS ACCOUNTABLE
New language is italicized and underlined
STRENGTHEN THE VOICE OF THE REGISTERED NURSE
- Nursing Care Committee – comprised of 55% direct inpatient care nurses
- One direct inpatient care nurse shall be selected annually by the direct inpatient care nurses to serve as the committee’s co-chair.
STRENGTHEN THE ROLE OF THE COMMITTEE IN DEVELOPING THE STAFFING PLAN
- Must meet at least 6 times a year
- Prepare & recommend to hospital administration the hospital’s written hospital-wide staffing plan
- If the plan developed by the committee is not adopted or if substantial changes are proposed – Chief Nursing Officer must provide a written explanation to the committee of the reasons the plan was not adopted or any substantial changes prior to being adopted by the hospital.
- Provide input and feedback on the following
- selection, implementation, and evaluation of minimum staffing levels for inpatient care units
- Selection, implementation, and evaluation of an acuity model to provide staffing flexibility that aligns changing patient acuity with nursing skills required.
- Selection, implementation, and evaluation of the written staffing plan
- Review nursing staffing plans for all inpatient areas – shall consider
- Patient outcomes;
- Complaints regarding staffing, including complaints about a delay in direct care nursing or an absence of direct care nursing;
- Number of hours of nursing care provided through an inpatient hospital unit compared with the number of inpatients served by the hospital unit during a 24-hour period;
- Aggregate hours of overtime worked by the nursing staff;
- The extent to which actual nurse staffing for each hospital inpatient unit differed from the staffing specified by the staffing plan; and
- Any other matter or changes to the staffing plan determined by the committee to ensure that the hospital is staffed to meet the health care needs of patients.
- Provide written report addressing A thru D listed above twice a year on the staffing plan that will be made available to all direct inpatient care nurses
- Provide a written report annually to the hospital’s governing board that addresses the staffing plan, changes made to the plan, impact of such changes, and recommendations for future nurse staffing changes.
- RN may report to the nursing care committee any variations where the nurse personnel assignment in an inpatient care unit is not in accordance with the adopted staffing plan and may make a written report to the nursing care committee based on the variations.
- If a registered nurse on an inpatient care unit objects to a shift-to-shift adjustment, the registered nurse may submit a written report to the nursing care committee.
- The nursing care committee shall develop a process to examine and respond to written reports on variations in unit staffing or shift to shift adjustments, including the ability to determine if a specific written report is resolved or should be dismissed.
WRITTEN STAFFING PLAN
- Prepared by a nursing care committee or committees
- Provide for minimum direct care professional registered nurse-to-patient staffing needs for each inpatient care unit, including inpatient emergency departments.
- The plan shall include the following considerations:
- The complexity of care is the number of assessments or reassessments needed, discharge planning, the volume of admissions, transfers, discharges, and referrals.
- The complexity of clinical professional nursing judgment needed to design and implement a patient’s nursing care plan – Nurse’s professional preparation and experience level, need for specialized equipment and technology, skill mix of support personnel, professional preparation, and experience.
- Patient Acuity and number of patients that require care
- Ongoing assessments of every unit – patient acuity level and number of nurses necessary to provide care
- Additional RNs available when the need arises
- Identify an acuity model for adjusting the staffing plan.
- Each hospital shall Implement the staffing plan and assign nursing personnel to each inpatient care unit, including inpatient emergency departments, in accordance, with the plan.
- Posted in a conspicuous and accessible location for both patients and direct care staff
- Copy of the written staffing plan shall be provided to any member of the general public upon request.
STRENGTHEN HOSPITAL ACCOUNTABILITY
- Every Hospital Must Have And Implement A Written Staffing Plan
- Fines for failing to adopt a staffing plan
- 60 days to provide a plan of correction
- Fines for pattern or practice of failing to comply with the plan of correction
- Fines increase on a second offense
- IDPH will publicly disclose violations
- Money from fines received related to Section 10.10 shall be deposited in the Nursing Education Scholarship Fund
- RNs report variations to the staffing plan to the committee.
- RN may file a complaint with IDPH.
- Retaliation prohibited. No hospital may discipline, discharge, or take any other adverse employment action against an employee solely because the employee expresses a concern or complaint regarding an alleged violation of this Section or concerns related to nurse staffing.
Should you have questions regarding the Nurse Staffing Improvement Act of 2021 or its implementation, please contact either: Susan Swart at firstname.lastname@example.org, Helga Brake at email@example.com, or Elaine Kemper at Elaine.Kemper@amitahealth.org