Illinois Nurse Staffing Laws

1. Illinois Nurse Staffing Laws And You!

2. Illinois EnvironmentNurse Staff Laws & Regulation Long-standing: • Nurse Practice and Advanced Nurse Practice Act • Hospital Licensing Act & Rules • Perinatal, Newborn, EMS/EMSC, Trauma • JCAHO Staffing Effectiveness Standards Recent: • Hospital Report Card Act (2004) • Prohibit Mandated Overtime (2005) • Adverse Event Reporting (2005)

3. Legislative Proposals Patient Safety = Nurse Staffing

4. California Experience 1999 Staff Ratio Law (unfunded mandate): • 4 years to implement • Staff nurses unhappy over lack of autonomy and breaks • Unit support services reduced, less assistive nursing personnel, ancillary services • Increased use of travelers, 11 hospital closings, and ER diversions Impact Study Data (2005) CaNOC Study – no significant difference in falls reduction or pressure ulcer incidence

5. Illinois Solution: Hospital Report Card Act Nurse Staffing = Public Information

6. What is HRCA Connection to Nurse Staffing? Public Access to Staffing Information (since 1/1/2004) • Nurse staff schedules • Nurse – patient assignment rosters • Training info – for hire and retention Hospital-specific Report to Public (starting 2007) • Nursing coverage • Report in standardized units to reflect RN, LPN, assistive nursing personnel hours/pt day, avg daily census, avg daily hours • Vacancy & turnover rates • Patient Outcomes • Surgical site infection • Ventilator-associated pneumonia • Central-line related bloodstream • Whistleblower protections

7. What are state mandated ratios? • Prescribes fixed number for nurse to patient assignment • Reduces staffing function to only one dimension • Presumes: • all nurses are equal • all patients have same need • all patient care units are alike

8. Mandated Nurse-Patient Ratios Ignores : • Nurse education & experience • Variances in patient acuity • Add’l nursing resources – e.g., unit clerks, patient care techs, patient transport • Evidence-based practice correlated to patient outcomes

9. “At All Times” Ratios

10. HRCA: Hospital-specific info Dynamic process -Provides public updated range of nurse staff information Correlates nurse staffing to patient outcomes Provides an ongoing & comprehensive picture of Illinois nurse staffing Mandated Ratios: Uniform-one size fits all Static fix - Addresses only one dimension of nurse staffing Does not correlate nurse staffing to patient outcomes Fails to reflect Illinois HRCA information and pitfalls of California experience What are the Main Differences?

11. Our Hospital:Nurse Staffing Matters

12. Illinois HC Workforce Initiatives Major Objective: Adequate numbers of qualified and available staff to deliver full range of safe, quality patient care services.

13. Addressing the Issue Multiple Stakeholders & Efforts: • Career Awareness • Educational Matters • Licensure Issues • Funding Support • Work Environment • Data Needs

14. Hospital/College Partnerships Objective - Increase Capacity: • Expand programming • Support Faculty • Improve Resource Utilization • Benchmark Best Practices

15. Staff Insights Feedback: • Questions • Expectations