Staffing Computations

7/27/2019 Staffing Computations

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STAFFING &DUTY

SCHEDULING

Pamela M. Veroy RN, MAN

Be

fair

In the

distribution

of duty hours

to your

nursingstaff.


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Staffing

Is the process of determining and

providing the acceptable number and mix

of nursing personnel to produce a desired

level of care to meet the patients demand.

Purpose: to provide each nursing unit

with an appropriate and acceptable

number of workers in each category toperform the nursing tasks required.


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Factors affecting staffing

1. The type, philosophy and objectives f

the hospital and the nursing service

2. the population served or the kind of

patients served whether pay or

charity

3. the number of patients and severity of

their illness-knowledge and ability of

nursing personnel are matched with the

actual care needs of patients


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7. layout of the various nursing units andresources available within the

department such as adequate equipment,

supplies and materials.

8. budget including the amount alloted to

salaries, fringe benefits, supplies,

materials and equipment;

9. professional activities and priorities in non-patient activities like involvement in

professional organizations, formal

educational development,

participation in research and staff development


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10. teaching program or the extent of staff

involvement in teaching activities

11. expected hours of work per annum of each

employee. This is influenced by the 40-hrweek law; and

12. patters of work schedule-traditional 5 days

per week, 8 hours per day; 4 days a week,

ten hours per day and three days off; or 3

days of 12 hours per day and 3 days off

per week.


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Nursing Care hours per patient/day according

to classification of patients per units

Cases/Patients NCH/Pt/Day Prof to Non ProfRatio

1. General Medicine 3.5 60:40

2. Medical 3.4 60:40

3. Surgical 3.4 60:40

4. Obstetrics 3.0 60:40

5. Pediatrics 4.6 70:30

6. Pathologic Nursery 2.8 55:45

7. ER/ICU/RR 6.0 70:30

8. CCU 6.0 80:20


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Patient Care Classification System

It is a method of grouping patients according to

the amount and complexity of their nursing care

requirements and the nursing time and skill they

require. Purpose:

1. Serve in determining the amount of nursing

care required, generally within 24 hours.

2. to determine the category of nursing

personnel who should provide that

care.


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Classification CategoriesLevel I-Self

Care orMinimal Care

-NCH1.5/pt/day

- Ratio 55:45

-Can take a bath on his own; feed himself; perform his

own ADL.-For discharge pt; non-emergency, newly admitteddont exhibit unusual s/s;

- requires little treatment and observation

Level II

ModerateCare or

IntermediateCare

-NCH 3/pt- Ratio 60:40

-Need some assistance in bathing, feeding, ambulatingfor short period.

-Extreme s/s of illness must have subsided or have notyet appeared

-May have slight emotional needs

-v/s taking ordered 3x/shift; with IVF/BT; are semi-conscious and exhibiting some psychosocial or socialproblems;

- periodic treatments and/or observations and/instructions


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Classification CategoriesLevel III

Total,Complete or

IntensiveCare

-NCM6hrs/pt/day

-Ratio 65:35

-Patient are completely dependent uponthe nursing personnel.

-They are provided complete bath, arefed, may or may not be unconscious,

with marked emotional needs; with v/smonitoring more than 3x/shift

-Maybe on continuous oxygen therapy,with chest or abdominal tubes

-They require close observation at leastevery 30 minutes for impendinghemorrhage, with hypo or hypertensionand/ or cardiac arrhythmia


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Classification Categories

Level IV-HighlySpecializedCritical Care

-NCH 6-9 ormore /pt/day

- Ratio 70:30or 80:20

-Need maximum level of nursing carewith a ratio of 80 professionals to 20non-professionals.

-Needs continuous treatment and

observation-With many medications, IV piggybacks; v/s monitoring every 15-30minutes; hourly output.

-There are significant changes indoctors orders


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Categories of Level of Care of Patients: Nursing Care

Hours/Pt/Day & Ratio of Prof-Non Prof

Levels of Care NCH Needed PerPt./Day

Ratio of Prof toNon-Prof

Level I Self-Careor Minimal Care

1.50 5:45

Level II Moderateor Intermediate

Care

3.0 60:40

Level II Total orIntensive Care 4.5 65:35

Level IV HighlySpecialized orCritical Care

6.0

7 or higher

70:30

80:20


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Percentage of patients at various levels of care

per type of hospital

Type of Hospital MinimalCare

ModerateCare

IntensiveCare

HighlySpl. Care

Primary Hospital 70 25 5 -

Secondary Hospital 65 30 5 -

Tertiary Hospital 30 45 15 10

Special TertiaryHospital

10 25 45 20


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Computing for the number of nursing

personnel needed

- should ensure that there is sufficient staff to coverall shifts, off-duties, holidays, leaves,

absences, and time for staff development

programs.

- The For ty-Hou r Week Law (Republ ic Act 5901)- for100 bed capacity and up

-Granting of the 3-day special privilege to govt.

employees by the Civil Service Commission as

perMemo randum Circu lar No. 6 ser ies of 1996

(birthdays, weddings, anniversaries, funerals

(mourning), relocation, enrollment or graduation leave,

hospitalization, and accident leave.


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Total No. working-Non working days & hours of

nursing personnel per year

Rights & Privileges Given EachPersonnel Per Year

Working Hours Per Week

40 hours 48 hours

1. Vacation Leave2. Sick Leave

3. Legal Holidays4. Special Holidays5. Special Privileges6. Off-Duties as per R.A. 59017. Continuing Education Program

Total Non-working Days per year

Total working days per yearTotal working hours per year

1515

1023

1043

152

2131,704

1515

1023

523

100

2652,120


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Relievers Needed

- To compute for relievers needed, the following shouldbe considered;

1. Average number of leaves taken each year------ 15

a. vacation 15

b. sick leave 52. Holidays -----------------------------------------------------12

3. Special Privileges as per CSC MC#6 s. 1996-------3

4. Continuing Educ. Prog. For professionals------------3Total Average Leave-------33


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To determine the relievers

needed

- divide 33 by number of working days per yeareach employee served (whether 213 or 265)

- result will be 0.15 per persons works for 40

hour/week

- result will be 0.12 per persons works for 48

hour/week

- multiply the computed reliever per person by thecomputed number of nsg personnel

- this will give you the total number of relievers


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Staffing FormulaTo i l lus trate:Find the number of nursing according to levels

of care needed.

1. Categorize the patients according to levels of care

needed

250 pts x 0.30 = 75 pts needing minimal care

250 pts x 0.45 = 112.5 pts needing moderate care

250 pts x 0.15 = 37.5 pts needed intensive care

250 pts x 0.01 = 25 pts need highly specialized250 nsg care


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2. Find the number of nursing care hours (NCH) needed

by patients at each level of care per day.

75 pts x 1.5 (NCH needed at Level I) = 112.5 MCH/day

112.5 pts x 3 (NCH needed at Level II) = 337.5 NCH/day

37.5 pts x 4.5 (NCH needed at Level II) = 168.75 NCH/day

25 pts x 6 (NCH needed at Level IV) = 150 NCH/day

Total 768.75 NCH/day

3. Find the total NCH needed by 250 patients per year.768.75 x 365 (days/yr) = 280,593.75 NCH/year


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4. Find the actual working hours rendered by each

nursing personnel per year.

8 (hrs/day) x 213 (working days/year) = 1,704(working hours/year)

5. Find the total number of nursing personnel

needed.

a. Total NCH per year = 280,593.75 = 165

Working hrs/year 1,704

b. relief x total nsg. Personnel = 165 x 0.15 = 25c. total nursing personnel needed 165 + 25 = 190

6 Categorize to professional and non professional


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6. Categorize to professional and non-professional

personnel ratio of prof to non-prof in a tertiary hospital

is 65:35

190 x .65 = 134 professional nurses

190 x .35 = 66 nursing attendants

7. Distribute by shifts

124 nurses x .45 = 56 nurses on AM shift

124 nurses x .37 = 46 nurses on PM shift124 nurses x .18 = 22 nurses on night shift

Total 124 nurses

66 nsg attendants x .45 = 30 nsg. attendants on AM shift

66 nsg attendants x .37 = 24 nsg attendants on PM shift

66 nsg attendents x .18 = 12 nursing attendants on noc

Total = 66 nursing attendants


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Assessing a Scheduling System

1. Ability to cover the needs of the unit2. quality to enhance the nursing personnel's

knowledge, training and experience

3. fairness to the staff fair share of weekends, holiday

offs, rotation patters for the whole year

including assignment to difficult or light or

undesirable units or shifts

4. stability the schedule must be harmonized with theirfamily or social activities of the nurse staff

5. flexibility ability to handle changes brought by

emergency leaves.


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Make a schedule in a weekly or monthlybasis and do cycle system with the staff

under the area assigned for fairness and

flexibility.


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A one-week cyclical schedule

Personnel S M T W T F S

7/3 Headnurse/Senior Nurse x x

Staff Nurse x x

Nsg. Att. x x

3/11 Staff Nurse x x

Nsg. Att. x x

11/7 Staff Nurse x x

Nsg. Att. x x

Gen. Rel. 3/11; 11/7 S. nurse3/11 3/11 11/7 x x 3/11 11/7

N. Att. 3/11 11/7 x 7/3 3/11 11/7 x

Documents

Staffing Computations