The Law affects inpatient care units, which specifically includes an operating room as well as any unit in which nursing care is provided to patients admitted to the hospital.
- Each hospital in Ohio must establish a hospital-wide nursing care committee (Committee) no later than 90 days after the bill becomes law. (by December 9, 2008)
- At least 50% of the Committee’s membership must consist of registered nurses (RNs) who provide direct patient care and who adequately represent all types of nursing care services provided in the hospital.
- The hospital’s chief nursing officer must be part of the Committee, and that individual is required to establish a mechanism for obtaining input regarding staffing recommendations from all nurses (RNs and LPNs) who provide direct patient care in the hospital.
- The Committee must evaluate the hospital’s nursing services staffing plan (staffing plan) if one exists, and recommend a staffing plan that is consistent with current, accepted standards set by private accreditation organizations or governmental entities. The staffing plan recommendation must address the following:
1. Selection, implementation, and evaluation of minimum staffing levels for all inpatient care units that ensure the hospital has a staff of competent nurses with the specialized skills needed to meet patient needs in accordance with evidence-based safe nurse staffing standards;
2. The complexity of complete care including but not limited to assessment on patient admission; volume of admissions, discharges, and transfers; evaluation of the progress of a patient’s problems; patient education needs; ongoing physical assessments; discharge planning; and the assessment of the need for patient referrals; Patient acuity and the number of patients cared for.
3. The need for ongoing evaluation of a unit’s patient and nurse staffing levels; and
4. The development of a hospital policy to identify additional nurses to employ when patients’ unexpected demands exceed the planned workload assignment.
- Each hospital must create an evidence-based written staffing plan that must be implemented no later than ninety days after the Committee is convened. (March 9, 2009) The staffing plan created must:
- At a minimum, reflect current standards established by private accreditation organizations or governmental entities;
- Be based on multiple nurse and patient considerations that yield minimum staffing levels for inpatient care units that ensure that the hospital has a staff of competent nurses with specialized skills need to meet patient needs; and Include the recommendations of the Committee.
- The Committee must conduct a review of the staffing plan at least once a year to evaluate how the plan affects patient outcomes; clinical management; and whether the plan facilitates a care delivery system that provides on a cost-effective basis, quality nursing care that is consistent with acceptable and prevailing standards of safe nursing care and evidence-based guidelines established by national nursing organizations. The Committee is to make recommendations regarding any revisions that should be made to the staffing plan.
- Each hospital must post a notice, in a conspicuous location in the hospital, informing the public of the availability of the staffing plan and who to contact to obtain a copy of the plan.