Staffing

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I am an LPN and have worked at a county jail for several years. We are now being told that NCCHC accreditation requires all staff nurses to be RNs. Is this true?

No, the standards do not require that all nurses be RNs. Standard C-07 Staffing requires that the RHA have sufficient numbers and types of heath staff to care for the inmate population. Other than requiring an RHA and a responsible physician (see A-02 Responsible Health Authority), we do not determine type of staff, numbers or ratios for staffing plans.

In C-07, compliance indicator #5 requires that the adequacy and effectiveness of the staffing plan be assessed by the facility’s ability to meet the health needs of the inmate population. Each facility may have differing staffing needs based on the scope of services offered on-site. In addition, qualified health care professionals should not be performing tasks beyond those permitted by their credentials (see C-01 Credentials). NCCHC survey teams and members of the Accreditation and Standards Committee take these variables into account when determining the adequacy of staffing plans at individual facilities.

— From CorrectCare Volume 32, Issue 3, Summer 2018

 
 

We are evaluating our staffing model. My question is whether a medical department can be staffed by all LPNs at night and on weekends, or do the standards require an RN on-site at those times?

In standard C-07 Staffing, the discussion states that number and types of qualified health care professionals required depend on the size of the facility, the types (e.g., medical, nursing, dental, mental health) and scope (e.g., outpatient, inpatient, specialty care) of health services delivered, the needs of the inmate population and the organizational structure (e.g., hours of service, use of assistants, scheduling). The staffing plan should take into account labor-intensive activities such as medication distribution, sick call and cell checks in segregated housing. Because the sufficiency of the staffing plan can be assessed by a number of factors, NCCHC does not have a prescribed nursing (RN or LPN) ratio. The adequacy and effectiveness of a staffing plan should be assessed by the facility’s ability to meet the health needs of the inmate population. The standards also require that qualified health care professionals do not perform tasks beyond those permitted by their credentials.
— From CorrectCare Volume 30, Issue 1, Winter 2016

 
 

Do the Standards have any requirements concerning how many inmates one nurse should be in charge of in a county jail?

Standard C-07 Staffing requires that a sufficient number of health staff of varying types provide inmates with adequate and timely evaluation and treatment, consistent with contemporary standards of care. The responsible health authority must approve the staffing plan and the adequacy and effectiveness of the staffing plan should be assessed by the facility’s ability to meet the health needs of the inmate population. The number and types of qualified health care professionals required depend on the size of the facility, the types and scope of health services delivered, the needs of the inmate population and the organizational structure. It is not possible to specify exact ratios, but the number of staff must be sufficient to ensure that there are no unreasonable delays in patients receiving necessary care. [Note: This reply is accurate for both the 2008 and 2014 editions of the Standards.]
— From CorrectCare Volume 28, Issue 2, Spring 2014

 
 

Our jail is evaluating its staffing plan. Do the standards require that registered nurses be staffed at the facility around the clock?

No, there is not a standard that requires RNs to be staffed at the facility around the clock. Staffing plans of NCCHC-accredited facilities vary based on facility size and needs. The standard that relates to your question is C-07 Staffing. It requires a sufficient number of health staff of varying types to provide inmates with adequate and timely evaluation and treatment consistent with contemporary standards of care. The responsible health authority must approve the staffing plan, and the adequacy and effectiveness of the plan should be determined based on the facility’s ability to meet the health needs of the inmate population.
— From CorrectCare Volume 27, Issue 3, Summer 2013