59A-3.243. Nursing Services

Each hospital shall have a nursing department organized and staffed to provide quality nursing care to each patient. The relationship of the nursing department to other units of the hospital shall be documented by an organizational chart.

(1) The nursing department shall have a written organizational plan that delineates lines of authority, accountability and communication, and shall assure that the following nursing management functions are fulfilled:

(a) Review and approval of policies and procedures that relate to qualifications and employment of nurses.

(b) Establishment of standards for nursing care and mechanisms for evaluating such care.

(c) Implementing approved policies of the nursing department.

(d) Assuring that a written evaluation is made of the performance of registered nurses and ancillary nursing personnel at the end of any probationary period and at a defined interval thereafter.

(2) The nursing department shall have written standards of nursing practice and related policies and procedures to define and describe the scope and conduct of patient care provided by the nursing staff. These policies and procedures shall be reviewed annually, revised as necessary, dated to indicate the time of the last review, signed by the responsible reviewing authority, and enforced.

(3) The nursing department shall maintain a list of licensed personnel, including private duty and per diem nurses, with each individual’s current license number, and documentation of the nurses’ hours of employment, and unit of employment within the hospital.

(4) Each hospital shall employ a registered nurse on a full time basis who shall have the authority and responsibility for managing nursing services and taking all reasonable steps to assure that a uniformly optimal level of nursing care is provided throughout the hospital.

(a) The registered nurse shall be responsible for ensuring that a review and evaluation of the quality and appropriateness of nursing care is accomplished. The review and evaluation shall be based on written criteria, shall be performed quarterly, and shall examine the provision of nursing care and its effect on patients.

(b) The registered nurse shall ensure that education and training programs for nursing personnel are available and are designed to augment nurses’ knowledge of pertinent new developments in patient care and maintain current competence. Cardiopulmonary resuscitation training shall be conducted as often as necessary, but not less than annually, for all nursing staff members who cannot otherwise document their competence.

(c) The registered nurse shall be responsible for determining the number of qualified registered nurses to be on duty at all times. The number of qualified nurses shall be sufficient to ensure immediate availability of a registered nurse for bedside care of any patient when needed, to assure prompt recognition of an untoward change in a patient’s condition, and to facilitate appropriate intervention by nursing, medical or other hospital staff members.

(5) The nursing process of assessment, planning, intervention and evaluation shall be documented for each hospitalized patient from admission through discharge.

(a) Each patient’s nursing needs shall be assessed by a registered nurse at the time of admission or within the period established by each hospital’s policy.

(b) Nursing goals shall be consistent with the therapy prescribed by the responsible member of the organized medical staff.

(c) Nursing intervention and patient response, and patient status on discharge from the hospital, must be noted on the medical record.

(6) Each Class I and Class II hospital shall have a minimum of one licensed registered nurse on duty at all times on each nursing unit or similarly titled part of the hospital for rendering patient care services.

Rulemaking Authority 395.1055 FS. Law Implemented 395.1055 FS. History–New 8-15-18.