Section 250.910  Nursing Services

The hospital shall provide an organized nursing service.

a)         Nursing Services – General Provisions

b)         The hospital shall maintain a staff of nursing personnel organized to provide the nursing care for its patients commensurate with the size, scope and nature of the hospital.

c)         Director of Nursing Administration

1)         The nursing service shall be under the direction of a registered professional nurse who has qualifications in nursing administration and who has the ability to organize, coordinate, and evaluate the service.

2)         The Nursing Administrator (Director of Nursing) shall be a registered professional nurse who holds a degree in nursing or has documented experience and relevant continuing education.  He/She shall be employed full-time within the hospital as director of the nursing administration.

3)         The Nursing Administrator shall be accountable to the Chief Executive Officer or designate for developing and implementing policies and procedures of the service and for the nursing practice.

4)         The Nursing Administrator should have authority over the selection, promotion and retention of nursing personnel based on established job descriptions.

d)         Assistants to the Nursing Administrator.

            A qualified registered nurse shall be designated and authorized to act in the absence of the nursing administrator on a 24 hour basis.

e)         Nursing Staff.

1)         A sufficient number of registered professional nurses shall be on duty at all times to assess, plan, assign, supervise, and evaluate nursing care and provide patients such nursing care for which the judgement and specialized skills of a registered nurse is required.

2)         Licensed practical nurses and other nursing personnel shall be qualified through training, education, and experience, and shall have demonstrated abilities to give nursing care that does not require the skill and judgement of a registered professional nurse.  Auxiliary nursing personnel shall be assigned and supervised by a professional nurse and shall be given only those duties for which they are trained.

3)         The number of registered professional nurses, licensed practical nurses and other nursing personnel assigned to each patient care unit shall be consistent with the types of nursing care needed by the patients and the capabilities of the staff.  Patients on each unit shall be evaluated near the end of each change of shift by criteria developed by the nursing service.

4)         Specific staffing requirements for particular units shall be followed as stated in other sections of this Part.

f)         Staffing Standards.

1)         There shall be staffing schedules reflecting actual nursing personnel required for the hospital and for each patient unit.  Staffing patterns shall reflect consideration of nursing goals, standards of nursing practice, and the needs of the patients.

2)         Staffing schedules shall accomplish the following:

A)        Identification of the nurse in charge of the patient care unit.

B)        Assignment of personnel in a manner which gives consideration to patient care plans and minimizes the risk of cross-infections.

C)        Projection of future time schedules indicating assignment of personnel by name, status, date and duty tour.

D)        Time schedules shall be kept in detail, indicating the assignment of nursing personnel by name, status, date, patient care unit, and duty tour.  Actual time reports shall be kept verifying personnel attendance by name date, patient care unit, and time of actual attendance.

(Source:  Added at 5 Ill. Reg. 507, effective December 29, 1980)