Nursing Services Requirements for the State of Connecticut
(j) Director of nurses.
(1) Qualifications.
(A) For
a chronic and convalescent nursing home, the director of
nurses, or any person acting in such capacity, shall be a
nurse registered in Connecticut with at least one (1) year
of additional education or experience in rehabilitative or
geriatric nursing and one (1) year of nursing service
administration.
(B) For a rest home with
nursing supervision, the director of nurses, or any person
acting in such capacity, shall be a nurse registered in
Connecticut with at least one (1) year of additional
education or experience in nursing service administration.
(2) The director of nurses shall be
responsible for the supervision, provision, and quality of
nursing care in the facility. The director of nurses' powers
and duties shall include, but not necessarily be limited to,
the following:
(A) development and maintenance of written nursing service
standards of practice, to be ratified by the governing body;
including but not necessarily limited to:
(i)definition of routine nursing care to be rendered by
licensed nursing personnel, and determination of when more than
routine care is needed; and
(ii)definition of routine care to be rendered by nurse's
aides, and determination of when more than routine care is
needed;
(B) coordination and integration of nursing services with
other patient care services through periodic meetings or
written reports;
(C) development of written job descriptions for nurses
and nurse's aides;
(D) development and annual review of nursing service
procedures;
(E) coordination and direction of the total planning for
nursing services, including recommending to the
administrator the number and levels of nurses and nurse's
aides to be employed;
(F) selection, with the administrator's approval, of all
nurses and nurse's aides;
(G) appointment of nurse supervisors as required by
subsection (k) of section 19-13-D8t
of the Regulations of Connecticut State Agencies;
(H) designation of a nurse in charge of each unit for all
shifts;
(I) development of a schedule of daily rounds and
assignment of duties for all nurses and nurse's aides to
assure twenty-four (24) hour coverage sufficient to meet
state regulatory requirements;
(J) assistance in the development of and participation in
a staff orientation and training program, in cooperation
with the administrator and medical director, as required
(K) by subsection (f) (3) (J) of section 19-13-D8t of the
Regulations of Connecticut State Agencies;
(L) ensuring yearly written evaluation of nurses and nurse's
aides;
(M) reporting significant clinical developments to the
patient's personal physician and to the medical director; and
(N) appointment, with the approval of the administrator, of a
nurse employed at the facility to act in the director's behalf
in temporary absences.
(3) The director of nurses shall
serve full-time and shall serve his/her entire shift between the
hours of 7 a.m. and 9 p.m.
(1) An assistant director of nurses
shall be appointed in any facility of one hundred and twenty
(120) beds or more.
(k) Nurse supervisor. A nurse supervisor shall be a
nurse registered in Connecticut. The responsibilities of the
nurse supervisor shall include:
(1) Supervision of nursing
activities during his/her tour of duty;
(2) Notification of a patient's
personal physician if there is a significant change in the
condition of the patient or if the patient requires immediate
medical care, or notification of the medical director if the
patient's personal physician does not respond promptly.
(m) Nursing staff:
(1) Each facility shall employ
sufficient nurses and nurse's aides to provide appropriate care
of patients housed in the facility 24 hours per day, seven days
per week.
(2) The number, qualifications, and experience of such
personnel shall be sufficient to assure that each patient:
(A) receives treatment, therapies, medications and
nourishments as prescribed in the patient care plan developed
pursuant to subsection (o) (2) (I) of these regulations;
(B) is kept clean, comfortable and well groomed;
(C) is protected from accident, incident, infection, or other
unusual occurrence.
(3) The facility's administrator and director of nurses shall
meet at least once every 30 days in order to determine the
number, experience and qualifications of staff necessary to
comply with this section. The facility shall maintain written
and signed summaries of actions taken and reasons therefore.
(4) There shall be at least one registered nurse on duty 24
hours per day, seven days per week.
In a chronic and convalescent nursing home, there shall
be at least one licensed nurse on duty on each patient occupied
floor at all times.
In a rest home with nursing supervision, there shall be
at least one nurse's aide on duty on each patient-occupied floor
at all times and intercom communication shall be available with
a licensed nurse.
(5) In no instance shall a
chronic and convalescent nursing home have staff below the
following standards:
Licensed nursing personnel:
7 a.m. to 9 p.m.: .47 hours per patient
9 p.m. to 7 a.m.: .17 hours per patient
(B) Total nursing and nurse's aide personnel:
7 a.m. to 9 p.m.: 1.40 hours per patient
9 p.m. to 7 a.m.: .50 hours per patient
(6) In no instance shall a rest home with nursing supervision
staff below the following standards:
Licensed nursing personnel:
7 a.m. to 9 p.m.: .23 hours per patient
9 p.m. to 7 a.m.: .08 hours per patient
Total nursing and nurse's aide personnel:
7 a.m. to 9 p.m.: .70 hours per patient
9 p.m. to 7 a.m.: .17 hours per patient
(7) In facilities of 61 beds or
more, the director of nurses shall not be included in satisfying
the requirements of subdivisions (5) and (6) of this subsection.
(8) In facilities of 121 beds or
more, the assistant director of nurses shall not be included in
satisfying the requirements of subdivisions (5) and (6) of this
subsection. |
