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Staffing for hospital

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STAFFING FOR NURSES IN A TERTIARY HOSPITAL WITH 250 BED

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Staffing for hospital

  1. 1. DEVANGI N SHARMA
  2. 2. DEVANGI N SHARMA
  3. 3. appropriate and acceptable number improper mixture high rates of absenteeism DEVANGI N SHARMA
  4. 4. TYPE PHILOSOPHY OBJECTIVES DEVANGI N SHARMA
  5. 5. • SCHEDULE Timetable showing planned work days and shift. • SCHEDULING Assigning work and off days to nursing personnel to assure adequate patient care. DEVANGI N SHARMA
  6. 6. determines : o How many people of what specific skills are needed in a specific department. determines: o Who o By name and skill o Will do what work and o When (specific time period) DEVANGI N SHARMA
  7. 7. Criteria for Effective Staffing • Coverage: The number of nurses assigned to be on duty should be in relation to the minimum number of nurses required • Quality: The total number of patient care should be planned in such a way that trained nurses are available for patient care of 24 hours a day. DEVANGI N SHARMA
  8. 8. Contd… • Stability: Allocation procedure must be consistent with leave and rotation policy. Each nurse must know her off, privileged leave etc. • Flexibility: The allocation policy must provide flexibility. • Objectives: There should be fairness in allocation and scheduling shift duties. DEVANGI N SHARMA
  9. 9. • Number of categories in which patient should be divided • Characteristics of patients/category • Type and number of care procedures needed by patient category • Time needed to perform the procedures DEVANGI N SHARMA
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  12. 12. 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. DEVANGI N SHARMA
  13. 13. 1. A patient who requires only minimal amount of nursing care (an average of 2.8 nursing hours per 24 hours) 2. A patient who requires average amount of nursing care (an average of 4.3 nursing hours per 24 hours) 3. A patient who requires above average nursing care (an average of 5.6 nursing hours per 24 hours) 4. A patient who requires maximum nursing care (an average of 8.6 nursing hours per 24 hours)DEVANGI N SHARMA
  14. 14. LEVEL OF CARE TYPE OF CARE NCH/ PPT/DAY RATIO OF PROF TO NON PROF LEVEL I SELF CARE OR MINIMAL CARE 1.50 55:45 LEVEL II MODERATE OR INTERMEDIATE CARE 3.0 60:40 LEVEL III TOTAL INTENSIVE CARE 4.5 65:35 LEVEL IV HIGHLY SPECIALIZED OR CRITICAL 6.0 70:30 DEVANGI N SHARMA
  15. 15. • Can take a bath on his own • Perform ADL • About to be discharged • Non- emergency case • No any unusual symptom DEVANGI N SHARMA
  16. 16. • Needs assistance in bathing, feeding or ambulating for short period of time • Extreme symptoms have subsided or yet to appear • Have slight emotional needs • With IVF or BT • Semi- conscious • Have some psychosocial problem • Periodic treatment, observation DEVANGI N SHARMA
  17. 17. • Completely dependent on nursing personnel • On continuous oxygen therapy • With chest or abdominal tubes • Requires close observation DEVANGI N SHARMA
  18. 18. • Needs continuous treatment & observation • Vital signs every 15 minutes • Input/output chart every hour DEVANGI N SHARMA
  19. 19. CASES/PATIENTS NCH/PT/DAY PROF TO NON PROF RATIO General medicine 3.5 60:40 Medical 3.4 60:40 Surgical 3.4 60:40 Obstetrics 3.0 60:40 Pediatrics 4.6 70:30 Pathology nursery 2.8 55:45 ER/ICU/RR 6.0 70:30 CCU 6.0 80:20DEVANGI N SHARMA
  20. 20. PERCENTAGE OF PATIENTS IN VARIOUS LEVELS OF CARE HOSPITAL TYPE LEVEL I LEVEL II LEVEL III LEVEL IV PRIMARY HOSPITAL 70 25 5 - SECONDARY HOSPITAL 65 30 5 - TERTIARY HOSPITAL 30 45 15 10 SPECIAL TERTIARY HOSPITAL 10 25 45 20 DEVANGI N SHARMA
  21. 21. RIGHTS & PRIVILEGES GIVEN TO EACH PERSONNEL WORKING HOURS PER WEEK PER YEAR 40 HOURS 48 HOURS VACATION LEAVE 15 15 SICK LEAVE 15 15 LEAGAL HOLIDAYS 10 10 SPECIAL HOLIDAYS 02 02 SPECIAL PRIVILAGES 03 03 OFF-DUTIES as per R.A 5901 104 52 CONTUNING EDUCATION PROGRAMME 3 3 TOTAL NON WORKING DAYS PER YEAR 152 100 TOTAL WORKING DAYS PER YEAR 213 265 TOTAL WORKING HOURS PER YEAR 1704 2120 DEVANGI N SHARMA
  22. 22. Someone who takes the place of another DEVANGI N SHARMA
  23. 23. Computing relievers needed… 1. Divide 33 (the average number of working days an employee is absent per year) by the number of working days per year that each employee serves (whether 213 or 265) 2. This will be 0.15 per person who works 40 hours per week and 0.12 per person for those working 48 hours per week 3. Multiply the computed reliever per person by the computed number of nursing personnel.DEVANGI N SHARMA
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  26. 26. The nursing hours needed by per category of patient in 24 hours assessed as… CATEGORY OF PATIENT MORNING SHIFT EVENING SHIFT NIGHT SHIFT TOTAL Completely Dependent 3.27 2.50 1.47 7.24 Partially Dependent 1.62 0.91 0.55 3.08 Ambulatory 1.20 0.70 0.17 2.07 6.09 4.11 2.10 12.29 DEVANGI N SHARMA
  27. 27. How to allocate nurses in each unit of hospital … DEVANGI N SHARMA
  28. 28. CATEGORY OF PATIENT DAILY AVERAGE TIME PER PATIENT IN 24 HOURS TOTAL PATIENT CALCULATION PER CATEGORY OF PATIENT TOTAL Completely dependent 7.24 20 7. 24 ×20 144.8 Partially dependent 3.08 25 3.08 × 25 77 Ambulatory patient 2.07 30 2.07 × 30 62.1 Total work load for 75 patients = 284 hours 283.9 hours DEVANGI N SHARMA
  29. 29. Working hours of 1 nurse per day= 8 Hrs/ day Total number of Nurses required: =284/8 = 36 nurses app. Calculating reliever when the leaves per nurse is 116 days / year. = 116/365 ×284/8 = 11 nurses Total nurses required = 36 + 11 = 47 NursesDEVANGI N SHARMA
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  31. 31. Categorize the number of patients according to the level of care needed Multiply total number of patient by % of patient at each level of care DEVANGI N SHARMA
  32. 32. • Find the number of patients at each level by the average number of NCH needed/day • Get sum of NCH needed at various level DEVANGI N SHARMA
  33. 33. Find the actual number of nursing care hours needed by the given number of patients/bed capacity per year • Total NCH needed/day x Total number of days in a year DEVANGI N SHARMA
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  39. 39. 1. Basavanthappa.B.T.,“ Nursing Administration,'' Jaypee brothers, medical publishers, New Delhi, first edition, 2000, pp. no.511-523. 2. Ernst.S.Nora & et al, "Nursing home staff development , "A guide for in-service programs, Springer publishing company, New York, copy rights (c), 1983, pp. no.6-7. 3. Marquis.L.Bessie, ‘’Leadership roles and management functions in nursing’’, Theory and applications, Lippincott, Philadelphia, Third edition, 2000, pp no.252-256. 4. Barrett.Jean, ‘’Ward management and teaching’’, Konark publications, New Delhi, ninth reprint edition, 1998, pp. no.346-347. 5. Wise. Yoder ‘Leadership and management in nursing’’, Mosby’s, printed at USA, first edition, 1995, pp. no.301-309. 6. https://www.scribd.com/doc/25102504/Staffing-in-Nursing-Management 7. https://www.scribd.com/doc/49818065/Staffing-Nursing-managementDEVANGI N SHARMA
  40. 40. MOTIVATION determines what you do ATTITUDE determines how well you do DEVANGI N SHARMA

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