California passes first nurse staffing quota law
In October 1999, California became the first state to pass legislation requiring minimum nurse-to-patient ratios for all patient care units in hospitals. The bill requires nurse staffing numbers to be based on:
- the severity of illness;
- the need for specialized equipment and technology;
- the complexity of clinical judgment needed to manage the patient care plan;
- ability for self-care;
- licensed level of staff.
The bill also prohibits the use of unlicensed personnel for nursing functions when an RN is not available and prevents non-RNs from performing nursing functions such as:
- medication administration;
- venipuncture or intravenous therapy;
- parenteral or tube feedings;
- invasive procedures, including inserting nasogastric tubes, inserting catheters, or tracheal suctioning;
- assessment of patient condition;
- patient and family education and post- discharge care;
- moderate complexity laboratory tests.
The bill also requires that orientation be provided for an RN coming into a nursing unit or clinical area as well as for temporary personnel.