Staffing Ratios & Safe Staffing at Kaiser Permanente — Northern California RNs & NPs

nurse-to-patient ratio in a postpartum area of the perinatal service shall be 1:4 mother-baby couplets or fewer at all times. In the event of multiple births, the total number of mothers plus infants assigned to a single licensed nurse shall never exceed eight. For postpartum areas in which the licensed nurse’s assignment consists of mothers only, the licensed nurse-to- patient ratio shall be 1:6 or fewer at all times. (5) The licensed nurse-to-patient ratio in a combined Labor/Delivery/ Postpartum area of the perinatal service shall be 1:3 or fewer at all times the licensed nurse is caring for a patient combination of one woman in active labor and a postpartum mother and infant. The licensed nurse-to-patient ratio for nurses caring for women in active labor only, antepartum patients who are not in active labor only, postpartum women only, or mother-baby couplets only, shall be the same …

rgency department shall be 1:4 or fewer at all times that patients are receiving treatment. There shall be no fewer than two licensed nurses physically present in the emergency department when a patient is present. At least one of the licensed nurses shall be a Registered nurse assigned to triage patients. The Registered nurse assigned to triage patients shall be immediately available at all times to triage patients when they arrive in the emergency department. When there are no patients needing triage, the Registered nurse may assist by performing other nursing tasks. The Registered nurse assigned to triage patients shall not be counted in the licensed nurse-to-patient ratio. Hospitals designated by the Local Emergency Medical Services (LEMS) Agency as a “base hospital”, as defined in section 1797.58 of the Health and Safety Code, shall have either a licensed physician or a Registered n …

board access shall not be unreasonably denied. A designated Association representative shall be responsible for posting material submitted by the Association, a copy of which shall be furnished to the Employer before posting. The Association agrees that no controversial material shall be posted. It is further agreed that the Employer shall post position vacancies as provided in Article IX of the contract on such bulletin boards. ARTICLE V – PERSONNEL CATEGORIES Section A – Probationary Nurses Regular Registered Nurses may be discharged without recourse to the grievance procedure within the first ninety (90) days of employment. Short- Hour, Temporary and Per diem Registered Nurses may be discharged without recourse to the grievance procedure until such Nurse has been employed for six (6) months or worked three hundred (300) hours, whichever comes first. Section B – Regular Nurses A Regula …

wer critical care patients at all times. A patient in the emergency department shall be considered a critical care patient when the patient meets the criteria for admission to a critical care service area within the hospital. Only Registered nurses shall be assigned to critical trauma patients in the emergency department, and a minimum Registered nurse-to-critical trauma patient ratio of 1:1 shall be maintained at all times. A critical trauma patient is a patient who has injuries to an anatomic area that: (1) require life saving interventions, or (2) in conjunction with unstable vital signs, pose an immediate threat to life or limb. APPENDIX K – SUMMARY OF STAFFING RATIOS FROM TITLE 22 REGULATIONS (9) The licensed nurse-to-patient ratio in a step-down unit shall be 1:4 or fewer at all times. Commencing January 1, 2008, the licensed nurse-to-patient ratio in a step-down unit shall be 1:3 …

APPENDIX K – SUMMARY OF STAFFING RATIOS FROM TITLE 22 REGULATIONS 70217. NURSING SERVICE STAFF. (a) Hospitals shall provide staffing by licensed Nurses, within the scope of their licensure in accordance with the following nurse-to-patient ratios. Licensed nurse means a Registered nurse, licensed vocational nurse and, in psychiatric units only, a licensed psychiatric technician. Staffing for care not requiring a licensed nurse is not included within these ratios and shall be determined pursuant to the patient classification system. No hospital shall assign a licensed nurse to a nursing unit or clinical area unless that hospital determines that the licensed nurse has demonstrated current competence in providing care in that area, and has also received orientation to that hospital’s clinical area sufficient to provide competent care to patients in that area. The policies and procedures of t …

d to another nurse. “Assist” means that licensed nurses may provide patient care beyond their patient assignments if the tasks performed are specific and time-limited. (1) The licensed nurse-to-patient ratio in a critical care unit shall be 1:2 or fewer at all times. “Critical care unit” means a nursing unit of a general acute care hospital which provides one of the following services: an intensive care service, a burn center, a coronary care service, an acute respiratory service, or an intensive care newborn nursery service. In the intensive care newborn nursery service, the ratio shall be 1 Registered nurse: 2 or fewer patients at all times. (2) The surgical service operating room shall have at least one Registered nurse assigned to the duties of the circulating nurse and a minimum of one additional person serving as scrub assistant for each patient-occupied operating room. The scrub a …

e Administrators, Nurse Supervisors, Nurse Managers, and Charge Nurses, and other licensed nurses shall be included in the calculation of the licensed nurse- to- patient ratio only when those licensed nurses are engaged in providing direct patient care. When a Nurse Administrator, Nurse Supervisor, Nurse Manager, Charge Nurse or other licensed nurse is engaged in activities other than direct patient care, that nurse shall not be included in the ratio. Nurse Administrators, Nurse Supervisors, Nurse Managers, and Charge Nurses who have demonstrated current competence to the hospital in providing care on a particular unit may relieve licensed nurses during breaks, meals, and other routine, expected absences from the unit. Licensed vocational nurses may constitute up to 50 percent of the licensed nurses assigned to patient care on any unit, except where Registered nurses are required pursuan …

s of diverse diagnoses and diverse age groups who require care appropriate to a medical/surgical unit. (12) The licensed nurse-to-patient ratio in a specialty care unit shall be 1:5 or fewer at all times. Commencing January 1, 2008, the licensed nurse-to- patient ratio in a specialty care unit shall be 1:4 or fewer at all times. A specialty care unit is defined as a unit which is organized, operated, and maintained to provide care for a specific medical condition or a specific patient population. Services provided in these units are more specialized to meet the needs of patients with the specific condition or disease process than APPENDIX K – SUMMARY OF STAFFING RATIOS FROM TITLE 22 REGULATIONS that which is required on medical/surgical units, and is not otherwise covered by subdivision (a). (13) The licensed nurse-to-patient ratio in a psychiatric unit shall be 1:6 or fewer at all times …