Monday January 21st 2019

Providing a path to safe staffing in Illinois

Knowledge is power, and the Illinois Nurses Association (INA) and a group of graduate students are working to ensure that nurses have the facts they need to ensure safe staffing in their facilities.

Specifically, they are developing a comprehensive toolkit that is aimed at educating staff nurses and others about the Illinois “Staffing by Patient Acuity” legislation, which was crafted by INA and signed into law on Aug. 24, 2007, according to INA Deputy Executive Director Sharon Canariato, MSN, MBA, RN.

INA and the Illinois Hospital Association subsequently wrote the rules, released in February 2010, which spell out how the law must be implemented in all facilities.

Briefly, the law requires every hospital to implement a staffing plan recommended by a committee of nurses comprised of at least 50 percent direct-care staff nurses. The plan must take into account a range of staffing issues, including admissions, discharges, and transfers; the complexity of each patient; the use of special equipment and patient goals; and the skill mix and experience of staff, according to INA.

While the law refers to minimum staffing levels, it’s only in the context of the other factors, such as patient acuity and skills.

Each hospital is mandated to identify an acuity model, or assessment tool, for each inpatient unit that provides flexibility so the required nursing skills are always aligned with changing patient needs.

Further, the staffing plan must be posted in an easily accessible location for patients and staff, and the nursing care/staffing committee must evaluate its effectiveness semi-annually.

Powerful law, lesser awareness

INA’s efforts to get the law enacted was a great achievement for staff nurses and patients. However, it became clear that nurses needed more information about the landmark measure.

“I noticed that when I gave presentations around the state, [a number of] staff nurses didn’t know the law existed,” said Canariato, who also is a member of the American Nurses Association’s (ANA) Congress on Nursing Practice and Economics. “I realized we needed to provide nurses with something concrete that would help them lead efforts to implement the law in their hospitals.”

In the meantime, several graduate nurses at Lewis University’s College of Nursing and Health Professions were trying to determine the focus of their practicum. After Canariato spoke with some of them about the acuity law, she and the students decided to team up to create the toolkit.

“A lot of nurses feel frustrated, overworked, and believe they can’t do anything about it,” said Nadyne Spurlock, BSN, RN, a nurse educator for the telemetry department at Palos Community Hospital and one of four graduate students from the education track who are working on the toolkit. “My hope is the toolkit will help nurses in the workplace understand that there is law that can help them provide enhanced care and better patient outcomes.”

The STAT (Staffing to Acuity Toolkit) Workbook is comprised of four modules, Spurlock explained. The first module focuses on the law itself, and it was previewed at a webinar INA hosted Nov. 9, 2010. It includes information on the law’s history, its dual purpose of promoting patient safety and enhancing nurses’ work environment; and detailed aspects of its two major components: the required written staffing plan and the nursing care committee responsible for drafting and evaluating the plan.

Canariato said modules will address other major factors, including the following:

• Guidance for recruiting nurses for the nursing care committee/staffing committee and helping them build their voice.

• Other key measures related to the staffing law, such as the “Hospital Report Card Act,” the “Hospital Licensing Act,” and the Joint Commission standard.

• Suggested strategies to either develop and roll out a staffing plan, or compare an existing one against state law.

• Guidance in taking committee minutes, developing policies and procedures, and strategies to deal with unresolved problems.

The toolkit utilizes many examples, scenarios, and checklists to make it as user-friendly as possible, according to Canariato and Melissa Dean, BSN, one of the four graduate students in the administration track working on the project and an ANA member.

It will be available in a hard-copy workbook, and some of the modules will allow for self-study and continuing education credit. Additionally, there will be modules available by webinar, and INA and the graduate students will be available for consultations to bring the toolkit live to hospitals to assist nurses at their worksites.

Beyond creating the toolkit, the graduate students created a survey for INA to use to cast a wider net in assessing staff nurses’ knowledge of the law, their hospitals’ implementation of the law, and their own sense of empowerment regarding staffing issues, according to Dean, who’s also the clinical and business manager of perioperative services at Mercy Medical Center in Dubuque, IA, and former Illinois resident.

Added Dean, “We’re pleased Illinois [lawmakers] passed this law that empowers nurses to make staffing decisions.”

That said, the students also are creating a marketing plan so staff nurses know about the toolkit, and in turn, this empowering law.

For more information, go to INA’s website at www.illinoisnurses.com.

— Susan Trossman is the senior reporter for The American Nurse.

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