National Nursing Shortage Reform and Patient Advocacy Act S 1031 (Boxer)
Sen. Boxer introduces S 1031 at nurse gathering in D.C.
Legislative Purpose
To address the nationwide shortage of hospital direct-care registered nurses; provide minimum safe patient protection standards — such as safe staffing ratios — for short-term and long-term acute-care hospitals in the United States; protect direct care registered nurse as patient advocate, create registered nurse education grants, and living stipends to recruit and retain direct-care registered nurses.
To create a hospital nursing service environment that will immediately attract new RNs and provide the foundation for ultimate restoration of the hospital direct RN workforce; and
To establish clearly defined, legally protected and enforceable duties and rights to direct-care registered nurses as advocates exclusively for the interests of patients.
Whistleblower protections that encourage patients, RNs and other healthcare workers to notify government and private accreditation entities of suspected unsafe patient conditions that will greatly enhance the health, welfare, and safety of patients.
The essential principles of staffing in the acute-care hospital settings must be based on patient’s individual acuity and needs; severity of conditions; services needed; and complexity surrounding those services.
Uniform National Professional Standards
1. Direct-Care Registered Nurse Patient Advocacy — Professional Duty of Patient Advocacy
- Professional Obligation and Right; an RN has the professional obligation and therefore the right to act as the patient’s advocate.
- Acceptance of Patient Care Assignments; the RN is always responsible for providing competent, safe, therapeutic, and effective nursing care to assigned patients.
- Free Speech — Whistleblowing — Patient Protection; all direct-care RNs responsible for patient care in a hospital facility shall enjoy the right of free speech.
2. Minimum, Specific, and Numerical Direct-Care Registered Nurse-to-Patient Staffing Ratios by Clinical Unit for Acute-Care Hospitals
(a) Unit-specific direct-care RN-to-patient ratios for all shifts at all times.
A patient classification system (PCS) to determine additional staff, based on a National Acuity Tool developed by CMS.
(b) The Direct-Care RN-to-Patient Ratios
Intensive/Critical Care 1:2; Neo-natal Intensive Care 1:2; Operating Room 1:1; Post-anesthesia Recovery 1:2; Labor and Delivery 1:2; Ante partum 1:4; New Born Nursery1:8; Postpartum couplets 1:4; Postpartum women only 1:6; Pediatrics 1:3; Emergency Room 1:3; ICU patients in the ER 1:2; Trauma patients in the ER 1:1; Step Down & Telemetry 1:3; Medical/Surgical 1:5; Other Specialty Care 1:4; Psychiatric 1:4; Rehabilitation Unit & SNF 1:5
(c) Direct-care LV/PN ratios study and its effect on patient care in hospitals.
3. Registered Nurse Workforce Initiative
Purpose: achieve immediate short-term mitigation and remedy of the nationwide nursing shortage.
(a) Basic Educational Assistance Benefit & Living Stipend
Creation of an education assistance entitlement program for eligible associate and baccalaureate degree applicants.
(b) Preceptorship and Mentorship Demonstration Project
4. Federal Assistance for the Purchase of Safe Patient Handling Equipment
5. Federal Safe Patient Handling Standards
6. Enforcement
- Action by the Secretary; Administrative action. The Secretary shall receive, investigate, and attempt to resolve complaints of violations.
- Fines for Violating Employee and Patient Rights; acute-care hospital that violates employee or patient rights under this Act shall be subject to civil penalties — $25,000.00
Read the Full Text of the Bill
