Staffing Hosp. Nsg. Services in Diff. Units

1. STAFFING/HOSPITAL NURSING
SERVICES IN DIFFERENT UNITS

2. Staffing/Hospital Nursing Services in
Different Unit
Introduction
Nursing profession is considered a caring profession to
begin with, it was an art and a vocation. Now its
considered a scientific profession nursing care is defined as
the care of the patient with specific regard to nursing
needs, with the ever increasing dimension of medical
sciences quantitatively and qualitatively nursing care is
becoming more and more complex with its management
service.

3. Nursing services
Nursing Service is the part of the total health organisation
which aims at satisfying the nursing needs of the
patients/community. In nursing service, the nurse works
with the members of allied disciplines such as dietetics,
medical social service, pharmacy etc. in supplying a
comprehensive programme of patient care in the hospital.
Definition of Nursing Services
WHO expert committee on nursing defines the nursing
services as the part of the total health organisation which
aims to satisfy the nursing needs of the community. The
major objective of the nursing services is to provide.

4. ORGANISATION OF NURSING SERVICES
|
CHIEF NURSING OFFICER
|
NURSING SUPDT.
|
DY. NURSING SUPDT.
|
ASSTT. NURSING SUPDT.
|
WARD SISTER - CLINICAL SUPERVISOR
|
STAFF NURSE -------->STUDENT NURSE

5. STAFFING / WARD MANAGEMENT
Management defined in a simple language is
to get the work done in a systematic way for
accomplishment of defined objectives based on
management of:-
• Man
• Money &
• Material

6. For an effective staffing management, a nurse
manager must apply the managerial skills:-
CONCEPTUAL SKILL
MANAGER
HUMAN SKILL TECHNICAL SKILL

7. OBJECTIVES OF STAFFING IN WARD
• Maximum comfort and happiness by way of pleasant
surroundings.
• Qualitative/Comprehensive care to the patient.
• Care based on patient’s needs.
• Accurate assessment of illness.
• Adequate material resources at all times.
• Health education to the patient and attendants.
• Managerial skills as and when required.
• Privacy at all levels.

8. EFFECTIVE STAFFING
An effective nursing is always based on
nursing process which is an organised and
systematic approach to nursing care, that
prioritizes patient assessment and
management.

9. Entire nursing process consists of four phases
• ASSESSMENT – Not only initial but an integral
ongoing component of the whole nursing process.
• PLANNING AND IMPLEMENTATION - In
this the nurse formulates and implements the care.
• EVALUATION – Decides whether the action taken
has met the identified needs or not. This is the final step
of care . Also , the review of the whole care plan.
Without this no quality care or comprehensive care is
possible to provide.

10. FACTORS TO BE CONSIDERED IN PLANNING
HOSPITAL NURSING SERVICES
• Number and type of patients.
• Number of beds and type of ward.
• The service required.
• Procedures / techniques necessary for care.
• Number and type of personnel needed to perform care
effectively.
• Physical facilities.
• Provision of equipment and supplies.

11. PLAN OF ACTION
• Assignment of personnel
a) Number
b) Category
c) Qualification
• Method
a) Functional
b) Team
c) Patient assignment (ICU)

12. • Analysis of total Nursing needs
a) Prepare a daily & weekly time-table.
b) Ensure adequate hours, meal –time, etc.
• Monitoring and Control
a) Supervision & Coordination.
b) Teaching & guidance to improve the quality
of work.
c) Maintain good Human relations.
d) Details of all activities to be performed such as:
i) Nursing Care.
ii) Management of Ward-personnel.

13. NURSING HOURS
Area No. of hours
Medical & Surgical Wards 3.2
Maternity ward 2.3
Neonatal ward 5.5
Pediatric ward 4.3
Communicable diseases ward 4.7

14. Master Staffing Pattern, INC, 1985
Area Nursing sister Staff Nurses
Gen. Wards 1:25 1:3
ICU, CCU 1 in each shift 1:1
L.R. 1 in each shift 4 in each shift
O.T. 1 in each shift 3 per table, each shift
OPD One overall, 1 in GOPD 1 in each deptt.
Casualty 1 in each shift 2-3 depending upon
admn.

15. NORMS Recommended for Nursing Service and
Education Indian Nursing year Book 2000-2001
Hospital Setting:
i. Nursing Supdt. - 1:200 beds (Hospitals with 200 or more beds)
ii. Dy. Nursing Supdt. - 1:300 beds (wherever beds are over 200)
iii. Asstt. Nursing Supdt. - 1:150 beds (wherever beds are over 150)
(7:1000 beds)
iv. Ward Sister /Ward Supervisor- 1:25 beds + 30% leave reserve.
v. Staff Nurses for ward - 1:3 or 1:9 for each shift + 30% Leave
reserve.
vi. for OPD Emergency etc.- 1:100 patients (1 bed :5 outpatients)+30%
leave reserve.
vii. for Intensive care units - 1:1 (or 1:3 for each shift) +30% leave
reserve
viii. for specialized deptt., such as operation theatre, labour room, etc
1.25+30% leave reserves

16. S.I.U. NORMS
• 1 nursing sister for 3:6 Staff Nurses
• 1 ANS for 4:5 nursing sisters.
• 1 DNS for 7:5 ANS.
• 1 Nursing Supdt. for 250 - 500 beds
• 1 CNO for 500 or more beds.

17. Placement of nursing staff
Normal Wards - 1:6 beds 1 nursing sister in every shift
Special Wards - 1:4 beds 1 nursing sister in every shift
Nursery - 1:2 beds 1 nursing sister in every shift
ICU / ICCU - 1 staff nurse/nursing sister for every bed.
Labour Room - 1 staff nurse / nursing sister in every bed/table
OT (Major) - 2 staff nurses / nursing sister for every functional
operating table including recovery room.
OT (Minor) - 1 staff nurse / nursing sister for every functional
operation table
Casualty (Main) -
Attendance upto 100 patients per day - 3 staff nurses / nursing sister for 24
hours i.e. per shift.
Thereafter for every additional - 1 staff nurse / nursing sister.
Attendance of 35 patients.

18. PROBLEMS AND CHALLENGES FACED
BY THE NURSING ADMINISTRATOR
• Lack of Adequate Training.
• Problem of Personnel Management.
• Inadequate number of Nursing Staff.
• Shortage of Trained manpower.
• Lack of Motivation.
• No Involvement in Planning.

19. cont.
• No Career Mobility.
• Poor Role Model.
• Non-Nursing Activities.
• No Research Scope.
• No Proper Authority.
• Professional Risk / Hazards.
• No Autonomy in Nursing Activities.

20. Constrains and Barriers in Nursing Service
Administration.
• Planning of Nursing Manpower.
• Management and Development.
• Staff Development.
• Development , Promotion.
• Rewards / Awards.
• Nursing Legislation.
• Trained Nurse Managers.

21. Cont.
• Diversification in Nursing Profession.
• Leadership Inadequacy.
• Lack of S.W.O.T.
• Lack of awareness to meet social, economic
and technical changes in the society and
Consumer Protection Act.
• Lack of Communication.
• Nursing Care Audit.

22. Day to Day Problem in Nursing
Services
• Shortage of Nurses.
• Lack of Motivation.
• Negative Attitude.
• Lack of Training.
• Lack of Leadership.
• Lack of Team Approach.
• Inactive Participation of Programmes.

23. cont.
• Lack of I.P.R.
• Less Involvement in Patients Care by the
Nursing Supervisors.
• Lack of Supervision of Sub-ordinates.

24. Foreseen for Better Nursing Service
Administration in the Next Millenium
• Accountability.
• Autonomy of Professional Activities.
• Authority of Management of Nursing personnel.
• Awareness of C.P.A.
• Independent Nursing Practice.
• Standard for Nursing Practice.
• Renewal of License Based On Education and
Examination.

25. cont.
• Specialty Nursing.
• Nursing Care Audit.
• Qualitative Nursing Care.
• Separate Nursing Budget.
• Diploma In Nursing Management.
• Nursing Research.

26. CONCLUSION
• In staffing / ward management, a Nurse plays a
crucial role. She must remember the function of a
nurse as defined by Virginia Henderson:
“The Unique function of a nurse is to assist an
individual sick or well, in the performance of those
activities contributing to health or its recovery (or
to peaceful death)”.

27. • Staffing / Ward Management is a team effort. One must
think it is a business of partnership in which all should
walk together with team-spirit.
“ Someone has blended the plaster, Someone has carried the
stone. Neither the man nor the Master, ever has built
alone”.
Only by working together, Things are accomplished by man
all have a share in the beauty. All have a share in the plan.
CONCLUSION Cont..