National Nurses United

For continuing education credit of 5.0 hours, please complete the following test, including the registration form at the bottom, and return to: NNU/Nursing Practice, 2000 Franklin St., Oakland, CA 94612. We must receive the complete home study no later than March 15, 2013 in order to receive your continuing education credit. 1. One of the key safety components of AB 394 is to ensure that patients had access to registered nurses. The safe staf���ng law directed the Department of Health Services to consider the RN Scope of Practice and Standards of Competent Performance in developing the minimum nurse-to-patient ratios. ��� True ��� False 2. The California ratio law has had a positive impact on recruitment and retention of RNs and has dramatically improved patient outcomes. ��� True ��� False 3. As a result of the increased complexity of critical care, and the use of sophisticated technology, the 1:2 RN-to-patient ratio in the intensive care unit setting is designated as the maximum number of patients which can be assigned to a competent RN at any one time. The ratio of RNs must be increased based on the patient���s severity of illness, level of dependency, and the experience of the nurses providing the care. ��� True ��� False 4. Step-down, telemetry, and medical/surgical units��� minimum nurseto-patient ratios are the same since there is no distinction between the level and complexity of care. ��� True ��� False 5. Whether the minimum nurse-to-patient ratio in the post-anesthesia care unit will be 1:2 or fewer at all times depends on the type of anesthesia the patient received. ��� True ��� False 6. RNs on a break are not counted for the purpose of compliance with the ratios; this means the RN on a break has transferred direct-care responsibilities to another RN whose assignment does not exceed the applicable ratios. ��� True ��� False 7. The judge���s ruling in the lawsuit ���led by the California Hospital Association (CHA) against the Department of Health Services (DHS) was in favor of the hospital industry, stating that ratios do not apply during meals and breaks because, despite the evidence cited in the ratio law, the hospital administrators must have ���exibility to assign more patients per nurse ���at all times.��� ��� True ��� False 8. Patient advocacy demands that RNs must always side with their managers and agree to double up on their assignments during meal and break time, or agree to transfer and discharge their patients to a lower level of care than is safe in the professional judgment of the RN, in order to protect their hospital���s budget and operating margin. ��� True ��� False 9. A hospital may take legitimate action against an RN for disclosing unsafe patient care conditions to government regulatory agencies, such as the Department of Health Services, because it may harm their patient satisfaction ratings. ��� True ��� False 10. The United States Nursing Shortage Reform and Patient Advocacy Act (SB 992, Boxer) and the Nurse Staf���ng Standards for Patient Safety and Quality Care Act (HR 2187, Schakowsky) are evidence-based companion bills based on existing California law that will expand nursing care and patient protection standards to the federal level. ��� True ��� False 11. One of the characteristics of a profession is that professionals have power over the practice of their discipline, which is often referred to as professional autonomy. A key element of nursing power is the ability to use one���s independent, professional clinical judgment to meet the individual needs of the patient. ��� True ��� False 12. The right and duty of the registered nurse to use independent professional clinical judgment to act as a ���whistle-blower��� and challenge an unsafe patient care assignment and assert the need for additional quali���ed staff is an important advocacy and patient safety tool. ��� True ��� False 13. Many direct-care RNs have the perception that their individual hospital���s acuity tool/patient classi���cation system (PCS) and staf���ng plans and ���committees��� are not meeting their patients��� needs for safe staf���ng. For this reason, SB 992 (Boxer) directs the Centers for Medicare and Medicaid Services (CMS) to develop a National Acuity Tool that provides a method for establishing nurse staf���ng requirements above the minimum staf���ng ratios, which uses the existing CMS computer-based ���hospital assigned DRG codes and patient severity of illness levels��� program. ��� True ��� False 14. According to California regulations, a ���telemetry unit��� is de���ned as a unit organized, operated, and maintained to provide care for and continuous cardiac monitoring of patients in a stable condition, having or suspected of having a cardiac condition or a disease requiring the electronic monitoring, recording, retrieval, and display of cardiac electrical signals. The minimum staf���ng ratio for a telemetry unit is 1:4 ��� True ��� False 15. Environmental and organizational factors in hospital settings associated with patient and family assaults on healthcare workers, lateral violence, higher error rates, increased patient morbidity/ mortality, and other hostile working conditions leading to increased nurse turnover/burnout include understaf���ng (especially during admission, transfer, discharge, and meal times); a high patient-pernurse ratio; and unrealistic/high-acuity patient workloads. ��� True ��� False Continuing Education Test RN Trailblazers: Ratios, Rights and Representation Name:________________________________________________________________________________________ Address: ______________________________________________________________________________________ City:______________________________________________ State:_________ Zip: __________________________ Day phone with message machine: _____________________________ Email: _______________________________ RN license #: ______________________________Job Classification: ______________________________________ NOVEMBER 2012 W W W. N AT I O N A L N U R S E S U N I T E D . O R G N AT I O N A L N U R S E 35

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