Scenario - Staffing is an important part of nursing management as healthcare is very labor intensive. Since nursing is a major expense in any institution it is oftentimes the area where administrators will try to save money, sometimes forsaking quality and increasing the chances that there will be disgruntled nurses after a short time. The following scenarios are for two units in the same hospital so acuity levels will be the same. Acuity levels are as follows: #1=4.0; #2=3.2; #3=2.3; #4=1.4. The first unit is the ICU. The second is a Med-Surg floor. (HINT: calculate on an 8hr shift first)

Here is your staffing for ICU: 3-RN's; 1-Unit Sec

Staffing for Med-Surg: 2-RN's; 2 LPN's; 1 Unit Sec

ICU Unit

• 6 patients = #1 acuity
• 2 pts = #2 acuity
• 0 pts = #3 acuity
• 0 pts = #4 acuity

Med-Surg Unit

• 0 pts. = #1 acuity
• 2 pts. = #2 acuity
• 4 pts. = #3 acuity
• 8 pts. = #4 acuity

Instructions:

1. Please calculate the proper staffing for each unit along with the hours for a unit secretary.
   • Be sure to show each step in your calculation with an explanation for each of the steps.
   • There is an explanation of this in your book on page 245-247.
2. Your paper should be:
   • One (1) page
   • Typed according to APA style for margins, formatting and spacing standards
   • Typed into a Microsoft Word document, save the file, and then upload the file

Answer:

Discusses Staffing, It Is Necessary To Briefly Discuss Here How Staffing Needs Are Expressed In The Personnel Budget. Most Staffing Is Based On A Predetermined Standard. This Standard could also be Addressed In Hours Per Patient-Day (HPPD) (Medical Units), Visits Per Month (Home Health Agencies), Or Minutes Per Case (The Operating Room). Because The Patient Census, Number Of Visits, Or Cases Per Day Never Remains Constant, The Manager Must Be able to Alter Staffing When Volume Increases Or Decreases.

The Standard Formula For Calculating medical care Hours Per Patient-Day (NCH/PPD)

Standard Formula For Calculating medical care Hours Per Patient-Day (NCH/PPD). (Copyright © 2006 Lippincott Williams & Wilkins. Instructor’s Resource CR-ROM To Accompany Leadership Roles And Management Functions In Nursing, By Bessie L. Marquis And Carol J. Huston.)

A Unit Manager In An Acute Care Facility Might Use This Formula To Calculate Daily Staffing Needs. For Example, Assume That Your Budgeted NCH Are 6 NCH/PPD. You Are Calculating The NCH/PPD For Today, January 31; in the dark , it'll Be February 1. The Patient Census in the dark Is 25 Patients. In Checking Staffing, you discover the subsequent Information:

Shift Staff On Duty Hours Worked

11:00 PM (1/30) To 7:00 AM (1/31) 2 RNs 8 H Each

1 LVN 8 H

1 CNA 8 H

7:00 AM To 3:00 PM (1/31) 3 RNs 8 H Each

2 LVNs 8 H Each

1 CNA 8 H

1 Ward Clerk 8 H

3:00 PM To 11:00 PM (1/31) 2 RNs 8 H Each

2 LVNs 8 H Each

1 CNA. 8 H

1 Ward Clerk 8 H

11:00 PM (1/31) To 7:00 AM (2/1) 2 RNs 8 H Each

2 LVNs 8 H Each

1 CNA 8 H

RNs, Registered Nurses; LVNs, Licensed Vocational Nurses; CNA, Certified Nursing Assistant.

Ideally, you'd Use 12 Midnight To Compute The NCH/PPD For January 31, But Most Staffing Calculations supported Traditional 8-Hour Shifts Are Made Beginning At 11:00 PM And Ending At 11:00 PM The Following Night. Therefore, during this Case, it might Be Acceptable to work The NCH/PPD For January 31 By Using Numerical Data From The 11:00 PM To 7:00 AM Shift Last Night And The 7:00 AM To 3:00 PM And 3:00 PM To 11:00 PM Shifts Today. The First Step during this Calculation Requires A Computation Of Total NCH Worked In 24 Hours (Including The Ward Clerk’s Hours). This Can Be Calculated By Multiplying the entire Number Of Staff On Duty Each Shift By The Hours Each Worked In Their Shift. Each Shift Total Then Is Added Together to urge the entire Number Of Nursing Hours Worked altogether Three Shifts Or 24 Hours: The Nursing Hours Worked In 24 Hours Are 136 Hours.

The Second Step In Solving NCH/PPD Requires that you simply Divide The Nursing Hours Worked In 24 Hours By The Patient Census. The Patient Census during this Case Is 25. Therefore, 136 / 25 = 5.44.

The NCH/PPD For January 31 Was 5.44, Which is a smaller amount Than Your Budgeted NCH/PPD Of 6.0. It Would Be Possible to feature Up To 14 Additional Hours Of medical care within the Next 24 Hours And Still Maintain The Budgeted NCH Standard. However, The Unit Manager Must Remember That the quality Is Flexible which Patient Acuity And Staffing Mix May Suggest the necessity For Even More Staff For February 1 Than The Budgeted NCH/PPD.

The Personnel Budget Includes Actual Worked Time (Also Called Productive Time Or Salary Expense) And Time That The Organization Pays the worker For Not Working (Nonproductive Or Benefit Time). Nonproductive Time Includes the value of advantages , New Employee Orientation, turnover rate , Sick And Holiday Time, And Education Time. For Example, the typical 8.5-Hour Shift Includes A 30-Minute Lunch Break And Two 15-Minute Breaks. Thus, This Employee Would Work 7.5 Productive Hours And Have 1.0 Hours Of Nonproductive Time.