question archive N5341 Staffing Module Assignment Preliminary Data Definition of Staffing Terms: To build a body of knowledge regarding the development of a staffing budget and later be able to create actual staffing plans, the registered nurse must first be familiar with the following terms and their definitions
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N5341 Staffing Module Assignment
Definition of Staffing Terms: To build a body of knowledge regarding the development of a staffing budget and later be able to create actual staffing plans, the registered nurse must first be familiar with the following terms and their definitions.
Nursing Hours Per Patient Day (NHPPD): A unit of measure that defines the average number of hours of nursing care delivered to each patient in a 24-hour period.
Hours Per Workload Unit (HPWU): A unit of measure that defines the average number of hours worked per workload unit. The workload unit can be number of visits, number of meals served, number of square feet cleaned, number of operating room minutes, and others, depending on the department worked.
There is a direct relationship between the workload and the amount of resources (RNs, LVNs, Aides, Dietary Aides, OR staff, etc.) needed.
Patient Day (PD): One patient occupying one bed for one day. Typically, counted at midnight. For example, a patient admitted to a nursing care unit at 11:50 p.m. will be counted in the midnight census for that unit; therefore will be counted as one patient day.
Average Daily Census: Patient days in a given time period (daily, weekly, monthly, or annual) divided by the number of days in the time period. It is also used to define the average number of total inpatients on any given day.
Variable Hours of Care: A component of NHPPD that measures the amount, in time, of care directly provided to the patient by a caregiver, e.g. RN, LVN, aide. It does not take into account fixed hours of care. Variable hours of care are also referred to as caregiver hours.
Fixed Hours of Care: A component of NHPPD that reflects the indirect care provided by nursing staff, e.g. unit secretary, nurse manager, clinical nurse specialist. This unit of measure is a constant, meaning that it is not dependent upon the acuity of the patient, or the volume of patients when calculating the staffing pattern.
Full-Time Equivalent (FTE): The equivalent of one full-time employee working for one year. It is calculated based upon 40 hours per week for 52 weeks, or 2080 hours. It includes both productive and nonproductive time. One employee, working full-time for one year (2080 hours) is one FTE. Two employees, each working 20 hours per week for one year (1040 hours each), are the equivalent of one FTE.
Replacement FTE: The number of FTEs required to replace non-worked hours.
Worked Hours: The actual number of hours worked, including both regular and overtime hours, orientation hours, on-call hours, callback hours, and training/education hours. Also known as productive hours.
Non-Worked Hours: The hours for which an employee is paid, but are not worked. Examples include vacation, sick, jury duty, holidays, funeral leave, paid time off, etc. The Fair Labor Standards Act dictates what an institution must include as non-worked hours. Also known as nonproductive hours.
Paid Hours: The total amount of worked and non-worked hours an employee is paid for.
Position: One person working one job, regardless of the number of hours that person works. A position is not the same as an FTE.
Shift: A designated number of hours that an employee works in a 24-hour period. A shift could be 4, 8, 10, 12, or even 16 hours in length. In this module, one shift will be considered as 8 hours.
Paid to Worked Ratio (PWR): Paid hours divided by the difference between paid and non-worked (nonproductive) hours. The PWR is calculated to determine the number of paid FTEs required. For example, one FTE is paid 2080 hours in one year. This FTE has 265 nonproductive hours (vacation, holiday, sick, etc.). PWR=2080/(2080-265)=1.15.
Worked FTE: The number of FTEs required to provide patient care on a daily, weekly, monthly, or annual basis.
Paid FTE: The actual number of worked FTEs plus the replacement FTEs needed during vacation, education, training, etc. to staff a cost center.
Cost Center: A unit or department in an organization.
Use the Excel™ Spreadsheet provided to document your answers. All calculations must be done using formulas in the spreadsheet, where applicable. Be sure to check your worksheet before submitting the assignment to ensure that when the reader clicks in a cell, the formula used to calculate the response is visible in the function bar.
Remember, an FTE is based upon the designated number of hours needed to cover a specified number of shifts during a specific time period. The time period may be per week, per pay period (usually two weeks) or per year. A shift is 8 hours of worked time. Below are some examples of how an FTE is calculated:
· FTE = Number of shifts assigned to work every pay period. A Full-time employee works 10 shifts every two weeks, and this equals 80 hours in a pay period. An employee who is full-time would not necessarily have to work 10 shifts as long as they worked 80 hours. However, for the purposes of this module, all shifts are to be considered 8 hours long, so the employee must work 10 shifts to be considered full-time.
· FTE = Worked hours hours per pay period for full-time employee
FTE = 40 worked hours 80 hours = 0.50 FTE
· Hours = FTE x Hours paid per pay period for full-time employee
· Hours = 0.50 FTE x 80 = 40 hours (number of hours that a 0.50 FTE would be scheduled to work in a pay period)
· Shifts = Hours per pay period Hours in a shift
Shifts = 80 hours per pay period 8 hours = 10 shifts per pay period
10 shifts = 80 hours per pay period = 1.00 FTE
9 shifts = 72 hours per pay period = 0.90 FTE
8 shifts = 64 hours per pay period = 0.80 FTE
7 shifts = 56 hours per pay period = 0.70 FTE
6 shifts = 48 hours per pay period = 0.60 FTE
5 shifts = 40 hours per pay period = 0.50 FTE
4 shifts = 32 hours per pay period = 0.40 FTE
3 shifts = 24 hours per pay period = 0.30 FTE
2 shifts = 16 hours per pay period = 0.20 FTE
1 shift = 8 hours per pay period = 0.10 FTE
For each of the following scenarios, complete your answers using your knowledge of Excel basic formulas on the Worksheet provided in the Assignment Drop Box:
FTEs |
ONE WEEK HOURS |
ONE WEEK SHIFTS |
ONE PAY PERIOD HOURS |
ONE PAY PERIOD SHIFTS |
0.2 |
8 |
1 |
16 |
2 |
0.4 |
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0.6 |
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0.8 |
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1.0 |
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2.0 |
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· FTEs = Total Shifts 5 shifts (shifts worked by 1 FTE per week)
· FTEs = An RN works 5 shifts per week. How many FTEs are required?
Now, it’s your turn again!!! Fill in the missing shifts and FTEs, using Excel formulas:
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*Format FTEs to 1 decimal place.
· NHPPD = Total shifts per week x 8 hours per shift
NHPPD* = ___________________________________
*Format NHPPD to 2 decimal places.
· Caregiver Hours = Total shifts of RNs, LVNs, & NAs x 8 hours per shift
Caregiver Hours = 91 x 8 = 8.56
Caregiver Hours* = __________________________
*Format the Variable Hours of Care (Caregiver Hours) calculation to 2 decimal places.
· Fixed Hours of Care = Total shifts of NM, US, etc x 8 hours per shift
Fixed Hours of Care = 12 x 8 = 1.13
Fixed Hours of Care* = ______________________
*Format calculation to 2 decimal places.
· Non-worked Hours = Total shifts non-worked x 8 hours per shift
An example of calculating Non-worked Hours for a full-time employee is as follows:
Sick leave = 10 shifts per year
Non-worked Hours = 40 shifts x 8 hours = 320 hours per employee
Sick leave = 12 shifts per year
Non-worked Hours = _________________
· PWR = Annual Paid Hours for a full-time employee
(Annual Paid Hours) – (Non-worked Hours)
Using an example of 320 non-worked hours per employee,
· Paid FTEs = Worked FTEs x PWR
*Format Paid FTEs to 2 decimal places
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*Format Paid FTEs to 2 decimal places.
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Okay. Now it’s time to give you a real brain teaser. Let’s see if you can put it all together.
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Inserting the appropriate data from above, calculate the following using formulas in Excel:
Calculate NHPPD: _____________________
Calculate Variable Hours: _________________
Calculate Fixed Hours: ____________________
· Paid NHPPD = Worked NHPPD x PWR
Paid NHPPD = 9.69 x 1.12 = 10.85
What is the Paid NHPPD with a Worked NHPPD of 15?
· Paid Caregiver Hours = Worked Caregiver Hours x PWR
The Variable Hours for that unit was 8.56. With a PWR of 1.12, calculate the Paid Caregiver Hours:
Paid Caregiver Hours = 8.56 x 1.12 = 9.59
What are the Paid Caregiver Hours with Worked Caregiver Hours of 7.25?
· Paid Fixed Hours = Worked Fixed Hours x PWR
Paid Fixed Hours = 1.13 x 1.12 = 1.26
What are the Paid Fixed Hours with Worked Fixed Hours of 1.6?
Just knowing your average daily census (ADC) and NHPPD may not be enough to create an accurate staffing pattern because these elements do not take into account the actual severity of the patients. If you are currently using an acuity system that assigns a numerical score to the severity level of the patients on your unit, you can adjust your staffing pattern to take into account the influence of patient severity.
· Acuity = Average Acuity Score x Patient Volume for a Specified Time
The Specified Time Period
You have calculated 12.85 NHPPD for a unit that has 61 patient days in one week (ADC=8.7). Assume an acuity on that unit of 2 (on average, each patient requires 2 RVUs); calculate Adjusted Daily Census (reflects acuity):
Acuity = 2 x 3176 Annual Patient Days
365 Days
Acuity = 6352 Adjusted Patient Days
Acuity = 17.4 Adjusted Daily Census
This value equals an adjusted average daily census that reflects the acuity of that patient population. The staffing pattern is then configured based on this adjusted average daily census. For example, with an ADC of 8.7 and NHPPD of 12.85, you would need 13.97 FTE. Factoring in the acuity value would indicate that you now need 27.9 FTE (17.4 patients * 12.85 NHPPD ÷ 8 hour shifts) to care for those 8.7 patients because of the acuity level.
To further see how FTEs change in relation to the addition of acuity, please follow this example:
A nursing unit has been told that they must maintain a worked NHPPD of 6.62 hours. The baseline workload unit volume is 12,500 patient days, requiring 39.78 worked FTEs. Remember how to calculate that? 6.62 NHPPD x 12,500 patient days = 82,750 hours/year. 82,750 2080 (hours worked by 1 FTE) = 39.78 worked FTEs. The workload unit volume, with an acuity of 1.08 factored, is now 13,500 patient days. The worked FTEs that would be required to care for this adjusted patient day volume would be:
FTEs = NHPPD x Adjusted Workload Volume
2080
An additional 3.19 FTEs are needed to account for the acuity of the patient population and to maintain a worked NHPPD of 6.62.
How many more FTEs would be needed with an acuity level of 3.0 for this same volume of patients and 6.62 NHPPD? Use formulas in Excel to calculate your answer.