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AHMC ANAHEIM REGIONAL MEDICAL CENTER
STAFFING AND DELIVERY OF CARE
Tag No.: A0392
Based on interview and record review, the hospital failed to ensure the nurse-to-patient ratios were maintained at all times for the Telemetry unit as required. This failure had the potential for the care needs of the patients not being met when the staffing ratio were not maintained as required.
Findings:
Review of the hospital's P&P titled Staffing and Ratio Guidelines dated 12/4/24, showed under the policy section, Anaheim Regional Medical Center (ARMC) follows California State Nurse Patient Ratio Laws.
The California Code of Regulations, Title 22, Division 5, Chapter 1, Article 3, 70217, (a) showed the following:
(10) The licensed nurse-to-patient ratio in a telemetry unit shall be 1:4 or fewer at all times.
On 2/5/25 at 1445 hours, an interview was conducted with RN 7. RN 7 stated on 1/20/25 day shift, three nurses began the shift at 0600 hours, which was out of ratio with a 1:5 (one nurse to five patients) ratio. RN 7 stated the charge nurse was able to locate an additional RN to work that morning, arrived at 1020 hours, and by 1030 hours, the RNs were at a 1:4 ratio. RN 7 stated the ratio on Telemetry should be 1:4.
1. Review of the hospital's P&P titled Staffing Ratio Guidelines dated 12/4/24, showed telemetry nurse to patient ratio is 1:4 per California state ratios.
Review of the Staffing Assignment for Tower 2 Telemetry dated 1/20/25, for the day shift showed the following:
* RN 1 was assigned four telemetry and one medical/surgical patients from 0600-1030 hours.
* RN 2 was assigned five telemetry patients from 0600-1030 hours.
* RN 3 was assigned three telemetry and three medical/surgical patients from 0600-1030 hours.
On 2/6/25 at 1123 hours an interview was conducted with the Chief Nursing Officer (CNO). The CNO stated when the nurses were assigned a mix assignment, that meant the assignements included the patients with different admission status orders such as telemetry and medical/surgical, the ratio assigned would base on the highest acuity patient, for example, one telemetry patient with three medical/surgical patients would be assigned at a telemetry ratio of 1:4.
On 2/6/25 at 1155 hours the CNO, Director of Quality and Risk Manager were notified and acknowledged the above findings.