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Staffing Levels for Patient Care Units
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- 10. • Appropriate staffing levels for a patient care unit reflect analysis of individual and aggregate patient needs. • There is a critical need to either retire or seriously question the usefulness of the concept of nursing hours per patient day. • Unit functions necessary to support delivery of quality patient care must also be considered in determining staffing levels.
- 11. • The specific needs of various patients’ population should determine the appropriate clinical competencies required of the nurse practicing in that area. • Registered nurse must have nursing management support and representation at both the operational level and the executive level. • Clinical support from experienced registered nurses should be readily available to those registered nurses with less proficiency.
- 12. • Organizational policy should reflect an organizational climate that values registered nurses and other employees are strategic assets and exhibit a true commitment to filling budgeted positions in a timely manner. • All institutions should have documented competencies for nursing staff including agency or supplemental traveling registered nurse for those activities that they have been authorized to perform. • Organizational policies should recognize the myriad needs of both patient and nursing staff.
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- 21. 96 𝑤𝑜𝑟𝑘𝑒𝑑 ℎ𝑜𝑢𝑟𝑠 40 𝑝𝑎𝑡𝑖𝑒𝑛𝑡𝑠
- 22. Table 5.1 Classification of Patient Care by Units, Nursing Care Hours/Patient/Day and Ratio of Registered Nurses to Non-Professional Staff Needed Patient Care units Nursing care Hours/Patient/Day Ratio of Nurses to Non- Professional Staff General Medicine 3.5 60:40 Medical 3.4 60:40 Obstetrics 3.0 60:40 Pediatrics 4.6 70:30 PICU/NICU 6.0 70:30 ER/SICU/PACU 6.0 70:30 MICU/CCU 6.0 80:20
- 23. Table 5.2 Classification of Patient Care by Units, Nursing Care Hours/Patient/Day and Ratio of Registered Nurses to Non-Professional Needed Levels of Care Nursing care Hours/Patient/Day Ratio of Nurses to Non- Professional Staff Level I Self-care or Minimal Care 1.5 55:45 Level II Moderate Care or Intermediate Care 3.0 60:40 Level III Total Care or Intensive Care 6.0 65:35 Level IV Highly Specialized or Critical Care 7.0 or higher 70:30 or 80:20
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- 25. Table 5.3 Classification of Patients by Levels of Care according to Type of Hospital with Percentage of Patients at Various Levels of Care Type of Hospital Levels of Care Minimal Care Moderate Care Intensive Care Highly Specialized Care Primary 70 25 5 - Secondary 65 30 5 - Tertiary 30 45 15 10 Special Tertiary 10 25 25 20
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- 28. Unit Staff Distribution Ward 1 Ward Supervisor (Nurse III) : 50 staff nurses 1 Senior Nurse (Nurse II) : 15 staff nurses 1 Staff Nurse (Nurse I) : 12 beds / patients / shift 1 Nursing Attendant :24 beds / shift Unit Nurse to Staff Ratio Critical Care 1 Ward Supervisor (Nurse III) : 30 staff nurses 1 Senior Nurse (Nurse II) : 15 staff nurses 1 Nursing Attendant :15 beds / shift
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- 40. Rights / Privileges Given Each Personnel Working Hours/Week 40 hours 48 Hours 1. Days of Vacation Leave 15 15 1. Days of Sick Leave 15 15 1. Legal Holidays 10 10 1. Special Holidays 2 2 1. Days for Continuing Education 3 3 1. Special Privileges 3 3 1. Off Duties R.A 5901 104 52 1. Expanded Maternity Leave (RA 11210) 105 1. Paternity Leave (RA 11210) 14 Total Non-working Days/ Year 152 100 Total Working Days/ Year 213 265 Total Working Hours / Year 1,704 2,120
- 43. 1. Categorizethenumberofpatientsaccordingtothelevelsofcareneeded.Multiplythetotal numberofpatientsbythepercentageofpatientsateachlevelofcare(minimal,moderate, intensive,andhighlyspecialized). 300(pts)x.30=90 patientsneedingminimalcare 300(pts)x.45=135 patientsneedingmoderatecare 300(pts)x.15=45 patientsneedingintensivecare 300(pts)x.10=30 patientsneedinghighlyspecializednursingcare Total 300patients
- 44. 2.Findthenumberofnursingcarehoursneededbythepatients ateachcategory level. Findthenumberofpatientsateachlevelbytheaveragenumberofnursingcare hoursneededperday. Getthesumofthenursingcarehours neededatthevariouslevel. 90ptsx1.5(NCHneededatlevelI) = 135NCH/day 135ptsx3(NCHneededatlevelII) = 405NCH/day 45ptsx4.5(NCHneededatlevelIII) = 202.5or203NCH/day 30ptsx6(NCHneededatlevelIV) = 180NCH/day Total 923NCH/day
- 47. 5. Find the total number of nursing care personnel needed. Divide the total number of nursing care needed per year by the actual number of working hour rendered by an employee per year. Find the number of relievers. Multiply the number of nursing personnel needed by 0.15 (for those working 40 hours per week) or by 0.12 (for those working 48 hourse per week). Add the number of relievers to the number of nursing personnel needed. Total NCH / year = 36,895 = 197.7 or 198 nursing personnel Working hours/year 1,704 Total Nursing Personnel x 0.15 = Number of relievers 198 x 0.15 = 29.7 or 30 relievers Total Nursing Personnel needed = 198 + 30 = 228
- 49. 1st week 2nd Week 3rd Week 4th Week No. NA ME S M T W T F S S M T W T F S S M T W T F S S M T W T F S A-1 X X X X X X X X B-1 X X X X X X X X
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- 55. 1st week 2nd Week 3rd Week 4th Week No. NAME S M T W T F S S M T W T F S S M T W T F S S M T W T F S A-1 X X X X X X X X B-1 X X X X X X X X
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