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Rt Staff To Patient Ratio

I am a respiratory therapist on a committee c other RT,s. We are working on a staffing grid that considers both financial and patient satisfaction. Our hospital covers an area about one block long by a half block wide c about 400 beds. Please let me know what has or has not worked for you. We base assignments on a point value system c 0700, 1100, & 1500 rounds days and 1900, 2300, & 0300 noc rounding times. WE have two weeks before presenting. Thanx in advance, Susanne  RCP  Central Valley California area

giuliana giuliana 61-65, F 1 Response Jan 22, 2010

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THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


SECTION 1. Section 1276.45 is added to the Health and Safety Code,
to read:
1276.45. (a) A health facility licensed pursuant to subdivision
(a), (b), or (f) of Section 1250 shall allocate sufficient numbers of
respiratory therapists so as to provide a respiratory
therapist-to-patient ratio as follows:
(1) In critical care units, burn units, labor and delivery,
postanesthesia units, and any other specialty units, one respiratory
therapist per four patients who are receiving respiratory care as
ordered by a physician.
(2) For patients in emergency departments requiring care in an
intensive care or critical care setting, one respiratory therapist
per four patients who are receiving respiratory care as ordered by a
physician.
(3) For patients in emergency departments who are being held
temporarily and who do not require care in an intensive care or
critical care setting, one respiratory therapist per two critical
care patients receiving respiratory care as ordered by a physician in
addition to the regularly scheduled emergency room staff.
(4) In step down units and telemetry units, one respiratory
therapist per six patients receiving respiratory care as ordered by a
physician.
(5) In newborn intensive care units, one respiratory therapist
specially trained in the respiratory care of the newborn per two
patients receiving respiratory care as ordered by a physician.
(6) In medical-surgical units, one respiratory therapist per 10
patients receiving respiratory care as ordered by a physician.
(7) There shall be a minimum of one respiratory therapist for
every 50 patients or fraction thereof in the hospital at all times.
(b) The ratios specified in subdivision (a) shall constitute the
minimum number of respiratory therapists that shall be allocated.
Additional staff shall be assigned in accordance with a documented
patient classification system for determining respiratory care
requirements, including, but not limited to, the severity of the
illness, the need for specialized equipment and technology, the
complexity of clinical judgment needed to design, implement, and
evaluate the patient care plan and the ability for self-care, and the
licensure of the personnel required for care.
(c) Direct care respiratory therapists responsible for
implementing care on the basis of the patient classification system
and administrators responsible for assigning patient care based on
the system shall demonstrate knowledge and competency in the use of
the particular system used by the specific facility.
(d) All health facilities licensed under subdivision (a), (b), or
(f), of Section 1250 shall adopt written policies and procedures for
training and orientation of respiratory therapist staff.
(e) (1) No respiratory therapist shall be assigned to a hospital
unit or clinical area unless that respiratory therapist has first
received orientation in that clinical area sufficient to provide
competent care to patients in that area and has demonstrated current
competence in providing care in that area.
(2) The written policies and procedures for orientation of
respiratory therapist staff shall require that all temporary
personnel receive the same amount and type of orientation as is
required for permanent staff.
(f) Requests for waivers to this section that do not jeopardize
the health, safety, and well-being of patients affected and that are
needed for increased operational efficiency may be granted by the
department to rural general acute care hospitals meeting the criteria
set forth in paragraph (2) of subdivision (a) of Section 1250.
SEC. 2. No reimbursement is required by this act pursuant to
Section 6 of Article XIIIB of the California Constitution because the
only costs that may be incurred by a local agency or school district
will be incurred because this act creates a new crime or infraction,
eliminates a crime or infraction, or changes the penalty for a crime
or infraction, within the meaning of Section 17556 of the Government
Code, or changes the definition of a crime within the meaning of
Section 6 of Article XIIIB of the California Constitution.