Brief Description: Enacting the Washington state patient safety act requiring hospital staffing plans for nursing services and establishing recordkeeping and reporting requirements.

Sponsors: Representatives Morrell, Campbell, Edwards and Simpson.

Hearing Date: 2/12/03

Staff: Chris Blake (786-7392).

Background:

Acute care hospitals are regulated by the Department of Health. They provide continuous accommodations, facilities, and services to patients requiring observation, diagnosis, or care over a period of at least 24 hours. They serve patients who may require surgery and interventional services, obstetrical and nursery services, emergency care units or services, critical care units or services, cardiology services, pediatric care services, rehabilitation units, oncology services, and laboratory services.

Among their responsibilities, hospitals are required to ensure that qualified and competent staff are available to operate in each department. Hospital staffing decisions must consider that licensed practical nurses and registered nurses that work for a hospital for an hourly wage cannot be forced to work overtime except in limited circumstances. One of these exceptions is where the employer cannot obtain staffing despite reasonable efforts. This exception does not apply in situations involving chronic staff shortages at the hospital.

Summary of Bill:

Hospitals are required to develop and implement a staffing plan for nursing services. The plan must be updated annually and submitted to the Department of Health (Department). The plan must: (1) establish a minimum number and ratio of registered nurses, licensed practical nurses, and unlicensed assistive personnel to staff each patient care unit; (2) be based on the particular features of each patient care unit; (3) include limits on using agency and traveling nurses; (4) be drafted to keep personnel within their scope of practice; (5) accommodate staff breaks and leave; and (6) include a semiannual internal review of compliance with the plan.

Patient care units must be staffed in accordance with the staffing plan and the staffing plan must be posted in each unit.

Hospitals must keep daily records of the numbers of patients and personnel in each patient care unit for each standard shift. Hospitals must post a list of qualified nursing care resources that are available to replace absent staff.

Twice a year hospitals must submit to the Department specific data regarding nurse staffing including the hours worked by each level of personnel, nursing care hours provided per patient day by unit, rates of pressure ulcers relative to the number of patients, the rate of patient falls, and nurse staff satisfaction rates. The Department may investigate any complaints that a hospital has violated the requirements of the staffing plan or its reporting obligations. The Department must conduct random compliance audits of at least 10 percent of the hospitals every year.

Appropriation: None.

Fiscal Note: Requested on February 6, 2003.

Effective Date: The bill takes effect ninety days after adjournment of session in which bill is passed.