State Codes and Statutes

Statutes > Texas > Health-and-safety-code > Title-4-health-facilities > Chapter-257-nurse-staffing

HEALTH AND SAFETY CODE

TITLE 4. HEALTH FACILITIES

SUBTITLE B. LICENSING OF HEALTH FACILITIES

CHAPTER 257. NURSE STAFFING

Sec. 257.001. DEFINITIONS. In this chapter:

(1) "Committee" means a nurse staffing committee required by

this chapter.

(2) "Department" means the Department of State Health Services.

(3) "Hospital" means:

(A) a general hospital or special hospital, as those terms are

defined by Section 241.003, including a hospital maintained or

operated by this state; or

(B) a mental hospital licensed under Chapter 577.

(4) "Patient care unit" means a unit or area of a hospital in

which registered nurses provide patient care.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

Sec. 257.002. LEGISLATIVE FINDINGS. (a) The legislature finds

that:

(1) research supports a conclusion that adequate nurse staffing

is directly related to positive patient outcomes and nurse

satisfaction with the practice environment;

(2) nurse satisfaction with the practice environment is in large

measure determined by providing an adequate level of nurse

staffing based on research findings and patient intensity;

(3) nurse satisfaction and patient safety can be adversely

affected when nurses work excessive hours; and

(4) hospitals and nurses share a mutual interest in patient

safety initiatives that create a healthy environment for nurses

and appropriate care for patients.

(b) In order to protect patients, support greater retention of

registered nurses, and promote adequate nurse staffing, the

legislature intends to establish a mechanism whereby nurses and

hospital management shall participate in a joint process

regarding decisions about nurse staffing.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

Sec. 257.003. NURSE STAFFING POLICY AND PLAN. (a) The

governing body of a hospital shall adopt, implement, and enforce

a written nurse staffing policy to ensure that an adequate number

and skill mix of nurses are available to meet the level of

patient care needed. The policy must include a process for:

(1) requiring the hospital to give significant consideration to

the nurse staffing plan recommended by the hospital's nurse

staffing committee and to that committee's evaluation of any

existing plan;

(2) adopting, implementing, and enforcing an official nurse

services staffing plan that is based on the needs of each patient

care unit and shift and on evidence relating to patient care

needs;

(3) using the official nurse services staffing plan as a

component in setting the nurse staffing budget;

(4) encouraging nurses to provide input to the committee

relating to nurse staffing concerns;

(5) protecting from retaliation nurses who provide input to the

committee; and

(6) ensuring compliance with rules adopted by the executive

commissioner of the Health and Human Services Commission relating

to nurse staffing.

(b) The official nurse services staffing plan adopted under

Subsection (a) must:

(1) reflect current standards established by private

accreditation organizations, governmental entities, national

nursing professional associations, and other health professional

organizations;

(2) set minimum staffing levels for patient care units that are:

(A) based on multiple nurse and patient considerations; and

(B) determined by the nursing assessment and in accordance with

evidence-based safe nursing standards;

(3) include a method for adjusting the staffing plan for each

patient care unit to provide staffing flexibility to meet patient

needs; and

(4) include a contingency plan when patient care needs

unexpectedly exceed direct patient care staff resources.

(c) The hospital shall:

(1) use the official nurse services staffing plan:

(A) as a component in setting the nurse staffing budget; and

(B) to guide the hospital in assigning nurses hospital-wide; and

(2) make readily available to nurses on each patient care unit

at the beginning of each shift the official nurse services

staffing plan levels and current staffing levels for that unit

and that shift.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

Sec. 257.004. NURSE STAFFING COMMITTEE. (a) A hospital shall

establish a nurse staffing committee as a standing committee of

the hospital.

(b) The committee shall be composed of members who are

representative of the types of nursing services provided in the

hospital.

(c) The chief nursing officer of the hospital is a voting member

of the committee.

(d) At least 60 percent of the members of the committee must be

registered nurses who:

(1) provide direct patient care during at least 50 percent of

their work time; and

(2) are selected by their peers who provide direct patient care

during at least 50 percent of their work time.

(e) The committee shall meet at least quarterly.

(f) Participation on the committee by a hospital employee as a

committee member is part of the employee's work time, and the

hospital shall compensate that member for that time accordingly.

The hospital shall relieve a committee member of other work

duties during committee meetings.

(g) The committee shall:

(1) develop and recommend to the hospital's governing body a

nurse staffing plan that meets the requirements of Section

257.003;

(2) review, assess, and respond to staffing concerns expressed

to the committee;

(3) identify the nurse-sensitive outcome measures the committee

will use to evaluate the effectiveness of the official nurse

services staffing plan;

(4) evaluate, at least semiannually, the effectiveness of the

official nurse services staffing plan and variations between the

plan and the actual staffing; and

(5) submit to the hospital's governing body, at least

semiannually, a report on nurse staffing and patient care

outcomes, including the committee's evaluation of the

effectiveness of the official nurse services staffing plan and

aggregate variations between the staffing plan and actual

staffing.

(h) In evaluating the effectiveness of the official nurse

services staffing plan, the committee shall consider patient

needs, nursing-sensitive quality indicators, nurse satisfaction

measures collected by the hospital, and evidence-based nurse

staffing standards.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

Sec. 257.005. REPORTING OF STAFFING INFORMATION TO DEPARTMENT.

(a) A hospital shall annually report to the department on:

(1) whether the hospital's governing body has adopted a nurse

staffing policy as required by Section 257.003;

(2) whether the hospital has established a nurse staffing

committee as required by Section 257.004 that meets the

membership requirements of that section;

(3) whether the nurse staffing committee has evaluated the

hospital's official nurse services staffing plan as required by

Section 257.004 and has reported the results of the evaluation to

the hospital's governing body as provided by that section; and

(4) the nurse-sensitive outcome measures the committee adopted

for use in evaluating the hospital's official nurse services

staffing plan.

(b) Information reported under Subsection (a) is public

information.

(c) To the extent possible, the department shall collect the

data required under Subsection (a) as part of a survey required

by the department under other law.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

State Codes and Statutes

Statutes > Texas > Health-and-safety-code > Title-4-health-facilities > Chapter-257-nurse-staffing

HEALTH AND SAFETY CODE

TITLE 4. HEALTH FACILITIES

SUBTITLE B. LICENSING OF HEALTH FACILITIES

CHAPTER 257. NURSE STAFFING

Sec. 257.001. DEFINITIONS. In this chapter:

(1) "Committee" means a nurse staffing committee required by

this chapter.

(2) "Department" means the Department of State Health Services.

(3) "Hospital" means:

(A) a general hospital or special hospital, as those terms are

defined by Section 241.003, including a hospital maintained or

operated by this state; or

(B) a mental hospital licensed under Chapter 577.

(4) "Patient care unit" means a unit or area of a hospital in

which registered nurses provide patient care.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

Sec. 257.002. LEGISLATIVE FINDINGS. (a) The legislature finds

that:

(1) research supports a conclusion that adequate nurse staffing

is directly related to positive patient outcomes and nurse

satisfaction with the practice environment;

(2) nurse satisfaction with the practice environment is in large

measure determined by providing an adequate level of nurse

staffing based on research findings and patient intensity;

(3) nurse satisfaction and patient safety can be adversely

affected when nurses work excessive hours; and

(4) hospitals and nurses share a mutual interest in patient

safety initiatives that create a healthy environment for nurses

and appropriate care for patients.

(b) In order to protect patients, support greater retention of

registered nurses, and promote adequate nurse staffing, the

legislature intends to establish a mechanism whereby nurses and

hospital management shall participate in a joint process

regarding decisions about nurse staffing.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

Sec. 257.003. NURSE STAFFING POLICY AND PLAN. (a) The

governing body of a hospital shall adopt, implement, and enforce

a written nurse staffing policy to ensure that an adequate number

and skill mix of nurses are available to meet the level of

patient care needed. The policy must include a process for:

(1) requiring the hospital to give significant consideration to

the nurse staffing plan recommended by the hospital's nurse

staffing committee and to that committee's evaluation of any

existing plan;

(2) adopting, implementing, and enforcing an official nurse

services staffing plan that is based on the needs of each patient

care unit and shift and on evidence relating to patient care

needs;

(3) using the official nurse services staffing plan as a

component in setting the nurse staffing budget;

(4) encouraging nurses to provide input to the committee

relating to nurse staffing concerns;

(5) protecting from retaliation nurses who provide input to the

committee; and

(6) ensuring compliance with rules adopted by the executive

commissioner of the Health and Human Services Commission relating

to nurse staffing.

(b) The official nurse services staffing plan adopted under

Subsection (a) must:

(1) reflect current standards established by private

accreditation organizations, governmental entities, national

nursing professional associations, and other health professional

organizations;

(2) set minimum staffing levels for patient care units that are:

(A) based on multiple nurse and patient considerations; and

(B) determined by the nursing assessment and in accordance with

evidence-based safe nursing standards;

(3) include a method for adjusting the staffing plan for each

patient care unit to provide staffing flexibility to meet patient

needs; and

(4) include a contingency plan when patient care needs

unexpectedly exceed direct patient care staff resources.

(c) The hospital shall:

(1) use the official nurse services staffing plan:

(A) as a component in setting the nurse staffing budget; and

(B) to guide the hospital in assigning nurses hospital-wide; and

(2) make readily available to nurses on each patient care unit

at the beginning of each shift the official nurse services

staffing plan levels and current staffing levels for that unit

and that shift.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

Sec. 257.004. NURSE STAFFING COMMITTEE. (a) A hospital shall

establish a nurse staffing committee as a standing committee of

the hospital.

(b) The committee shall be composed of members who are

representative of the types of nursing services provided in the

hospital.

(c) The chief nursing officer of the hospital is a voting member

of the committee.

(d) At least 60 percent of the members of the committee must be

registered nurses who:

(1) provide direct patient care during at least 50 percent of

their work time; and

(2) are selected by their peers who provide direct patient care

during at least 50 percent of their work time.

(e) The committee shall meet at least quarterly.

(f) Participation on the committee by a hospital employee as a

committee member is part of the employee's work time, and the

hospital shall compensate that member for that time accordingly.

The hospital shall relieve a committee member of other work

duties during committee meetings.

(g) The committee shall:

(1) develop and recommend to the hospital's governing body a

nurse staffing plan that meets the requirements of Section

257.003;

(2) review, assess, and respond to staffing concerns expressed

to the committee;

(3) identify the nurse-sensitive outcome measures the committee

will use to evaluate the effectiveness of the official nurse

services staffing plan;

(4) evaluate, at least semiannually, the effectiveness of the

official nurse services staffing plan and variations between the

plan and the actual staffing; and

(5) submit to the hospital's governing body, at least

semiannually, a report on nurse staffing and patient care

outcomes, including the committee's evaluation of the

effectiveness of the official nurse services staffing plan and

aggregate variations between the staffing plan and actual

staffing.

(h) In evaluating the effectiveness of the official nurse

services staffing plan, the committee shall consider patient

needs, nursing-sensitive quality indicators, nurse satisfaction

measures collected by the hospital, and evidence-based nurse

staffing standards.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

Sec. 257.005. REPORTING OF STAFFING INFORMATION TO DEPARTMENT.

(a) A hospital shall annually report to the department on:

(1) whether the hospital's governing body has adopted a nurse

staffing policy as required by Section 257.003;

(2) whether the hospital has established a nurse staffing

committee as required by Section 257.004 that meets the

membership requirements of that section;

(3) whether the nurse staffing committee has evaluated the

hospital's official nurse services staffing plan as required by

Section 257.004 and has reported the results of the evaluation to

the hospital's governing body as provided by that section; and

(4) the nurse-sensitive outcome measures the committee adopted

for use in evaluating the hospital's official nurse services

staffing plan.

(b) Information reported under Subsection (a) is public

information.

(c) To the extent possible, the department shall collect the

data required under Subsection (a) as part of a survey required

by the department under other law.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.


State Codes and Statutes


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State Codes and Statutes

Statutes > Texas > Health-and-safety-code > Title-4-health-facilities > Chapter-257-nurse-staffing

HEALTH AND SAFETY CODE

TITLE 4. HEALTH FACILITIES

SUBTITLE B. LICENSING OF HEALTH FACILITIES

CHAPTER 257. NURSE STAFFING

Sec. 257.001. DEFINITIONS. In this chapter:

(1) "Committee" means a nurse staffing committee required by

this chapter.

(2) "Department" means the Department of State Health Services.

(3) "Hospital" means:

(A) a general hospital or special hospital, as those terms are

defined by Section 241.003, including a hospital maintained or

operated by this state; or

(B) a mental hospital licensed under Chapter 577.

(4) "Patient care unit" means a unit or area of a hospital in

which registered nurses provide patient care.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

Sec. 257.002. LEGISLATIVE FINDINGS. (a) The legislature finds

that:

(1) research supports a conclusion that adequate nurse staffing

is directly related to positive patient outcomes and nurse

satisfaction with the practice environment;

(2) nurse satisfaction with the practice environment is in large

measure determined by providing an adequate level of nurse

staffing based on research findings and patient intensity;

(3) nurse satisfaction and patient safety can be adversely

affected when nurses work excessive hours; and

(4) hospitals and nurses share a mutual interest in patient

safety initiatives that create a healthy environment for nurses

and appropriate care for patients.

(b) In order to protect patients, support greater retention of

registered nurses, and promote adequate nurse staffing, the

legislature intends to establish a mechanism whereby nurses and

hospital management shall participate in a joint process

regarding decisions about nurse staffing.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

Sec. 257.003. NURSE STAFFING POLICY AND PLAN. (a) The

governing body of a hospital shall adopt, implement, and enforce

a written nurse staffing policy to ensure that an adequate number

and skill mix of nurses are available to meet the level of

patient care needed. The policy must include a process for:

(1) requiring the hospital to give significant consideration to

the nurse staffing plan recommended by the hospital's nurse

staffing committee and to that committee's evaluation of any

existing plan;

(2) adopting, implementing, and enforcing an official nurse

services staffing plan that is based on the needs of each patient

care unit and shift and on evidence relating to patient care

needs;

(3) using the official nurse services staffing plan as a

component in setting the nurse staffing budget;

(4) encouraging nurses to provide input to the committee

relating to nurse staffing concerns;

(5) protecting from retaliation nurses who provide input to the

committee; and

(6) ensuring compliance with rules adopted by the executive

commissioner of the Health and Human Services Commission relating

to nurse staffing.

(b) The official nurse services staffing plan adopted under

Subsection (a) must:

(1) reflect current standards established by private

accreditation organizations, governmental entities, national

nursing professional associations, and other health professional

organizations;

(2) set minimum staffing levels for patient care units that are:

(A) based on multiple nurse and patient considerations; and

(B) determined by the nursing assessment and in accordance with

evidence-based safe nursing standards;

(3) include a method for adjusting the staffing plan for each

patient care unit to provide staffing flexibility to meet patient

needs; and

(4) include a contingency plan when patient care needs

unexpectedly exceed direct patient care staff resources.

(c) The hospital shall:

(1) use the official nurse services staffing plan:

(A) as a component in setting the nurse staffing budget; and

(B) to guide the hospital in assigning nurses hospital-wide; and

(2) make readily available to nurses on each patient care unit

at the beginning of each shift the official nurse services

staffing plan levels and current staffing levels for that unit

and that shift.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

Sec. 257.004. NURSE STAFFING COMMITTEE. (a) A hospital shall

establish a nurse staffing committee as a standing committee of

the hospital.

(b) The committee shall be composed of members who are

representative of the types of nursing services provided in the

hospital.

(c) The chief nursing officer of the hospital is a voting member

of the committee.

(d) At least 60 percent of the members of the committee must be

registered nurses who:

(1) provide direct patient care during at least 50 percent of

their work time; and

(2) are selected by their peers who provide direct patient care

during at least 50 percent of their work time.

(e) The committee shall meet at least quarterly.

(f) Participation on the committee by a hospital employee as a

committee member is part of the employee's work time, and the

hospital shall compensate that member for that time accordingly.

The hospital shall relieve a committee member of other work

duties during committee meetings.

(g) The committee shall:

(1) develop and recommend to the hospital's governing body a

nurse staffing plan that meets the requirements of Section

257.003;

(2) review, assess, and respond to staffing concerns expressed

to the committee;

(3) identify the nurse-sensitive outcome measures the committee

will use to evaluate the effectiveness of the official nurse

services staffing plan;

(4) evaluate, at least semiannually, the effectiveness of the

official nurse services staffing plan and variations between the

plan and the actual staffing; and

(5) submit to the hospital's governing body, at least

semiannually, a report on nurse staffing and patient care

outcomes, including the committee's evaluation of the

effectiveness of the official nurse services staffing plan and

aggregate variations between the staffing plan and actual

staffing.

(h) In evaluating the effectiveness of the official nurse

services staffing plan, the committee shall consider patient

needs, nursing-sensitive quality indicators, nurse satisfaction

measures collected by the hospital, and evidence-based nurse

staffing standards.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.

Sec. 257.005. REPORTING OF STAFFING INFORMATION TO DEPARTMENT.

(a) A hospital shall annually report to the department on:

(1) whether the hospital's governing body has adopted a nurse

staffing policy as required by Section 257.003;

(2) whether the hospital has established a nurse staffing

committee as required by Section 257.004 that meets the

membership requirements of that section;

(3) whether the nurse staffing committee has evaluated the

hospital's official nurse services staffing plan as required by

Section 257.004 and has reported the results of the evaluation to

the hospital's governing body as provided by that section; and

(4) the nurse-sensitive outcome measures the committee adopted

for use in evaluating the hospital's official nurse services

staffing plan.

(b) Information reported under Subsection (a) is public

information.

(c) To the extent possible, the department shall collect the

data required under Subsection (a) as part of a survey required

by the department under other law.

Added by Acts 2009, 81st Leg., R.S., Ch.

742, Sec. 1, eff. September 1, 2009.


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