Illinois Nurse Staffing Laws

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Illinois Nurse Staffing Laws

• And You!

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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)

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Legislative Proposals

• Patient Safety Nurse Staffing

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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

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Illinois Solution Hospital Report Card Act

• Nurse Staffing Public Information

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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

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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

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Mandated Nurse-Patient Ratios

• Ignores
• Nurse education experience
• Variances in patient acuity
• Addl nursing resources e.g., unit clerks,
  patient care techs, patient transport
• Evidence-based practice correlated to patient
  outcomes

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At All Times Ratios
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What are the Main Differences?

• 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

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Our Hospital Nurse Staffing Matters
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Illinois HC Workforce Initiatives

• Major Objective
• Adequate numbers of qualified and
  available staff to deliver full range of
  safe, quality patient care services.

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Addressing the Issue

• Multiple Stakeholders Efforts
• Career Awareness
• Educational Matters
• Licensure Issues
• Funding Support
• Work Environment
• Data Needs

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Hospital/College Partnerships

• Objective - Increase Capacity
• Expand programming
• Support Faculty
• Improve Resource Utilization
• Benchmark Best Practices

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Staff Insights

• Feedback
• Questions
• Expectations