Académique Documents
Professionnel Documents
Culture Documents
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 to perform the nursing tasks required.
Nursing Care hours per patient/day according to classification of patients per units
Cases/Patients 1. General Medicine 2. Medical
NCH/Pt/Day Prof to Non Prof Ratio
3.5 3.4
60:40
60:40
60:40 60:40 70:30 55:45 70:30 80:20
3. Surgical
4. Obstetrics 5. Pediatrics
3.4
3.0 4.6
6. Pathologic Nursery
7. ER/ICU/RR 8. CCU
2.8
6.0 6.0
Classification Categories
Level I-Self Care or Minimal Care -NCH 1.5/pt/day - Ratio 55:45 Level II Moderate Care or Intermediate Care -NCH 3/pt - Ratio 60:40 -Can take a bath on his own; feed himself; perform his own ADL. -For discharge pt; non-emergency, newly admitted dont exhibit unusual s/s; - requires little treatment and observation -Need some assistance in bathing, feeding, ambulating for short period. -Extreme s/s of illness must have subsided or have not yet appeared -May have slight emotional needs -v/s taking ordered 3x/shift; with IVF/BT; are semiconscious and exhibiting some psychosocial or social problems; - periodic treatments and/or observations and /instructions
Classification Categories
Level III Total, Complete or Intensive Care -NCM 6hrs/pt/day -Ratio 65:35
-Patient are completely dependent upon the nursing personnel. -They are provided complete bath, are fed, may or may not be unconscious, with marked emotional needs; with v/s monitoring more than 3x/shift -Maybe on continuous oxygen therapy, with chest or abdominal tubes -They require close observation at least every 30 minutes for impending hemorrhage, with hypo or hypertension and/ or cardiac arrhythmia
Classification Categories
Level IVHighly Specialized Critical Care -NCH 6-9 or more /pt/day - Ratio 70:30 or 80:20
-Need maximum level of nursing care with a ratio of 80 professionals to 20 non-professionals. -Needs continuous treatment and observation -With many medications, IV piggy backs; v/s monitoring every 15-30 minutes; hourly output. -There are significant changes in doctors orders
Categories of Level of Care of Patients: Nursing Care Hours/Pt/Day & Ratio of Prof-Non Prof
Levels of Care Level I Self-Care or Minimal Care Level II Moderate or Intermediate Care Level II Total or Intensive Care Level IV Highly Specialized or Critical Care NCH Needed Per Pt./Day 1.50 3.0 Ratio of Prof to Non-Prof 5:45 60:40
70 65 30
25 30 45
5 5 15
10
10
25
45
20
Total No. working-Non working days & hours of nursing personnel per year
Rights & Privileges Given Each Personnel Per Year
1. Vacation Leave 2. Sick Leave 3. Legal Holidays 4. Special Holidays 5. Special Privileges 6. Off-Duties as per R.A. 5901 7. Continuing Education Program Total Non-working Days per year Total working days per year Total working hours per year Working Hours Per Week 40 hours 15 15 10 2 3 104 3 152 213 1,704 48 hours 15 15 10 2 3 52 3 100 265 2,120
b. sick leave 5
2. Holidays -----------------------------------------------------12 3. Special Privileges as per CSC MC#6 s. 1996-------3 4. Continuing Educ. Prog. For professionals------------3 Total Average Leave-------33
Staffing Formula
To illustrate: 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
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
= 150
NCH/day
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
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
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 shift 124 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
4. stability the schedule must be harmonized with their family or social activities of the nurse staff
5. flexibility ability to handle changes brought by emergency leaves.
Make a schedule in a weekly or monthly basis and do cycle system with the staff under the area assigned for fairness and flexibility.
Nsg. Att.
11/7 Staff Nurse Nsg. Att. Gen. Rel. 3/11; 11/7 S. nurse N. Att.
x
x x
3/11 3/11 11/7 x
x
x x
x 3/11 11/7
3/11
11/7
7/3
3/11
11/7