I.

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 patient’s demand.
 The Hospital Nursing Service Administration Manual of the Department of Health has
recommended the following nursing care hours (NCH) for patients in the various nursing
units of the hospital.

Patient classification systems (PCS)

 Quantify the quality of nursing care by matching patients’ needs to numbers and kinds of
nursing personnel using time as the unit of measure.
 A nurse manager must determine the following:
 Number of categories in which the pt should be divided
 Characteristics of pts per category
 Type & number of care procedures that will be needed by a pt per category
 Time needed to perform these procedures that will be required
A. PURPOSES
1. For staffing
2. Program costing and formulating budget
3. Track changes in patient care methods
4. Determine values for productivity equation
5. Determine quality
Table 1. Nursing Care Hours / patient / day according to classification of patients by units.
Cases/Patients NCH/Pt/Day (NHPPD) Prof. to Non Prof. Ratio

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
Table 2. Levels of Care of patients, NCH/pt/day & ratio or prof & non-prof
Levels of Care NHPPD Ratio
Level 1
Self Care Minimal Care 1.50 55:45
Level 2
Moderate Immediate Care 3.0 60:40
Level 3
Total Intensive Care 4.5 65:35
Level 4
Highly Specialized Critical Care 6.0 or higher 80:20
Table 3. Percentage of patients at various levels of care per type of hospital.
Type of Hospital Minimal Care Moderate Care Intensive Care Critical Care

Primary 70 25 5 -
Secondary 65 30 5 -
Tertiary 30 45 15 10
Special Tertiary 10 25 45 20
Table 4. Total number of working hours and non-working days and hours of nursing
personnel per year.
Rights and Privileges Given Each Personnel per Working Hours Per Week
Year 40 hours 48 hours Unit
1. Vacation Leave 15 15
2. Sick Leave 15 15
3. Legal Holidays 10 10 D
4. Special Holidays 2 2 A
5. Special Privileges 3 3 Y
6. Off- Duties (R.A. 5901) 104 52 S
7. Training 3 3
---------- -----------
Total Non-Working Days Per Year 152 100 Days
Total Working Days Per Year 213 265 Days
Total Working Hours Per Year 1704 2496 Hours
 B. COMPUTING FOR THE NUMBER OF NURSING PERSONNEL
When computing for the nursing personnel, one should ensure that there is sufficient staff to
cover:
1. All shifts
2. Off-duties
3. Holidays
4. Leaves
5. Absences
6. Time for Staff Development
• ACCORDING TO R.A. 5901 OTHERWISE KNOWN AS “THE FORTY-HOUR WEEK
LAW”, EMPLOYEES WILL WORK FOR 40HRS/WK:
1. FOR HOSPITALS WITH 100-BED CAPACITY OR MORE
2. COMMUNITY POPULATION OF AT LEAST 1 MILLION
• THERE ARE BENEFITS ENJOYED BY THE PERSONNEL REGARDLESS OF THE
WORKING HOURS. AS PER CIVIL SERVICE COMMISSION MEMORANDUM
CIRCULAR NO. 6, SERIES OF 1996, GOVERNMENT EMPLOYEES ARE GRANTED 3
DAYS WHICH MAY BE SPENT FOR:
1. Birthdays
2. Weddings
3. Anniversaries
4. Funerals (mourning)
5. Relocation
6. Enrolment/graduation leave
7. Hospitalization
8. Accident leaves
 To compute for relievers needed, the following should be considered:
1. Ave. number of leaves taken each year---------------- 15
◦ Vacation Leave -----------------------------10
◦ Sick Leave------------------------------------ 5
2. Holidays ------------------------------------------------------ 12
3. Special Privileges ------------------------------------------- 3
4. Continuing Education Program for Professionals--- 3
Total Average Leaves 33
 To determine the relievers needed:
33 (ave # of days an employee is absent)
213 or 265
(# of working days/year that each employee serves)
= 0.15 (15%) for persons who work 40hrs/wk = 0.12 (12%) for persons who work 48hrs/wk
 To distribute the staff by shifts:
Morning shift = 45 – 51% (0.45 – 0.51)
Afternoon shift= 34 – 47% (0.34 – 0.47)
Night shift = 15 – 18% (0.15 – 0.18)
***Note: In the Philippines, the distribution usually followed is 45% (0.45) for the morning
shift, 37% (0.37) for the afternoon shift and 18% (0.18) for the night shift.

C. CLASSIFICATION CATEGORIES
Level I- SELF CARE or MINIMAL CARE
• patient can take a bath on his own, feed himself and perform his ADL.
• patient about to discharge, those non-emergency, newly admitted do not exhibit
unusual symptoms, and requires little tx/observation or instruction.
• 1.5 NCH/ 55:45 ration prof and non prof
Level II- MODERATE CARE or INTERMEDIATE CARE
• patients under this level need some assistance.
• extreme symptoms of their illness must have subside or have not yet appeared.
• slight emotional needs, w/ V/S ordered up to 3x/shift, intravenous fluid or blood
transfusion, are semiconscious and exhibiting some psychological or social problems;
periodic tx, observation & instructions.
• 3 NCH / 60:40 ration prof & non-prof
Level III- COMPLETE or INTENSIVE CARE
• patients in this category are completely dependent upon the nursing personnel.
• they are with marked emotional needs, w/ V/S more than 3x/shift, may be on
continuous O2 therapy, w/ chest or abdominal tubes.
• require close observation at least 30 mins for impending hemorrhage, w/ or w/o hypo
or hypertension & cardiac arrhythmia.
 • 6 NCH / 65:35 Ration prof & non-prof
Level IV- HIGHLY or SPECIALIZED CARE
• Need maximum nursing care.
• patients need continuous tx & observation; w/ many medication, IV piggy banks; V/S
q 15-30 mins; hourly output.
• 6-9 NCH / 70:30 to 80:20
D. STAFFING FORMULA
1. Categorize the patients according to levels of care. Multiply the total # of patients by the % of
patients at each level of care.
Ex. Find the # of nursing personnel needed for 250 bed capacity in a tertiary hospital
250 (pts) x .30 = 75 pts need L1
250 (pts) x .45 = 112.5 pts need L2
250 (pts) x .15 = 37.5 pts need L3
250 (pts) x .10 = 25 pts need L4
2. Find the # of nursing care hrs (NCH) needed by patients at each level of care/ day.
75 pts x 1.5 (NCH at L1) =112.5 NCH/day
112.5 pts x 3 (NCH at L2) =337.5 NCH/day
37.5 pts x 4.5 (NCH at L3)=168.75 NCH/day
25 pts x 6 (NCH at L3) =150 NCH/day
Total = 76
3. Find the total NCH needed by given number of patients or bed capacity/year.
768.75 x 365 (days) = 280,593.75 NCH/year
4. Find the actual number of working hours rendered by each nursing personnel/year.
8 (hrs/day) x 213 (working days/year) = 1,704 (working hrs/year)
5. Find the total # of nursing personnel needed. (immediate, reliever, total personnel)
a. Total NCH/year = 280,593.75 = 165
working hrs/yr 1,704
b. Relief x total immediate nsg personnel
165 x 0.15 = 25
c. Total nsg. Personnel needed
165 + 25 = 190
6. Categorize the nursing personnel into professional and non-professional.
190 x .65 = 124 professional nurses
190 x .35 = 66 nursing attendants
190 nursing personnel
7. Distribute by shift
124 x .45 = 56 nurses on AM shift
124 x .37 = 46 nurses on PM shift
124 x .18 = 22 nurses on Night shift
124 nurses
66 x .45 = 30 nsg attendants on AM shift
66 x .37 = 24 nsg attendants on PM shift
66 x .18 = 12 nsg attendants on Night shift
66 nursing attendants
II. SCHEDULING
A. SCHEDULE
• It is a timetable showing planned work days and shift for nursing personnel.
• Scheduling is to assign working days and days off to the nursing personnel so that
adequate patient care is assured.
B. ASSESSING A SCHEDULING SYSTEM
1. Ability to cover the needs of the unit.
2. Quality to enhance the nursing personnel’s knowledge, training and experience.
3. Fairness to the staff
4. Stability
5. Flexibility
C. COMPONENTS OF PATIENT CLASSIFICATION SYSTEM
 Classification categories
• Factor
• Prototype
 Guidelines
 Average care time for a patient in each category
 Method for calculating required staffing, personnel mix, and required nursing care
hours
III. HUMAN RESOURCE DEPARTMENT
• involves tasks like interviewing, hiring, coaching, retention of state and
performance evaluation/appraisal
A. Personnel - are persons employed in an agency or department
B. Recruitment - the process of enlisting personnel for employment; the process of hiring
C. Selection - the process of choosing or selecting candidates according to their qualifications
to the job; the process of elimination
D. Retention - capacity to retain employees once they are hired

Modes of Recruitment
 Employee recommendation
 Word of mouth
 Advertisement
 Flyers
 Newsletter
 Bulletin
 Posters
 Career Days
 Job Fairs
 Placement

Screening Potential Staff

 Philosophies in the screening process:
 The manager should screen out applicants who do not fit the agency’s
image.
 The manager should try to fit the job to a promising applicant.
 Usually the manager should try to fit the applicant to the job.
 Application Forms and Resumes
 Determine whether the applicant meets minimal hiring requirements.
 Furnish background data useful in planning the selection interview.
 Obtain names of references who may be contacted for additional
information about the applicant’s work experience and general character.
 Collect information for personnel administration (SSN, # of dependents
etc.).
Letter of Reference
 Interview
◦ face to face contact between the job seeker and a person with full authority to fill
the position under discussion.
◦ The purpose of the interview is to obtain information, to give information, and to
determine if the applicant meets the requirements for the position.
 Types of Interview
Directive interview – uses closed-ended question
Non-directive interview – the applicant narrates himself.
Structure interview – the interviewer uses pre-prepared guidelines for interview.
Group interview – several applicants or interviewees are interviewed together.
Board interview – conducted by selected member of the personnel to an applicant.
 Test Used in Selection of Applicant
Aptitude Test – measures capacity on potential ability to learn
Psychomotor – measures strength and coordination
Job knowledge
Proficiency – measures how well the applicants can do a simple work
Psychological test – measures personality characteristics