25474360 nursing leadership

7/29/2019 25474360 Nursing Leadership

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Nursing Leadership

and Management

Organizing andStaffingPresented by:

BSN 4C 2


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-ANTHEA-


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ORGANIZING!!!Nice Organ!!!!


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Organizing

It is the process of establishing formal authority.

It involves setting up the organizational structure

through identification of groupings, roles andrelationships, determining the staff needed bydeveloping and maintaining staffing patterns anddistributing them in various areas as needed.

It includes developing job descriptions bydefining the qualifications and functions ofpersonnel.


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Elements of Organizational Structure

Setting up the Organizational Structure

Staffing

Scheduling Developing Job Description


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Understanding the organizational structure as awhole facilitates the development of roles andrelationships to enable the achievement of goals.

The organizational structure refers to the process bywhich a group is formed, its channel of authority,span of control and lines of communication.Departmentalization and division of work provideorderliness in administration. Through a breakdownof activities each individual becomes responsible fora specified set of activities and performs such.

Setting up the Organizational Structure


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Purposes of Setting up the Organizational

Structure:

It informs members of their responsibilitiesso that they may carry them out.

It allows the manager and the individual

workers to concentrate on his/her specificrole and responsibilities.

It coordinates all organizational activities so

there is minimal duplication of effort andconflict


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It reduces the chances of doubt and

confusion concerning assignments.

It avoids overlapping of functions because it

pinpoints responsibilities.

It shows to whom and for whom they are

responsible.


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Purposes of Setting up the Organizational

Structure

It informs members of their responsibilitiesso that they may carry them out.

It allows the manager and the individual

workers to concentrate on his/her specificrole and responsibilities.

It coordinates all organizational activities so

there is minimal duplication of effort andconflict


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The organizational structure of the Nursing

Service should be updated, reviewed,

approved and documented by the proper

authority. Date of last review should be

documented.


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The purpose of all staffing activities is to provide

each nursing unit with an appropriate and acceptable

number of workers in each category to perform the

nursing tasks required. Too few or an impropermixture of nursing personnel will adversely affect the

quality and quantity of work performed. Such

situation can lead to high rates of absenteeism and

staff turn-over resulting in low morale anddissatisfaction.

Staffing


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The objective in scheduling is to assign

working days and days off to the nursing

personnel so that adequate patient care is

assured. A desirable distribution of off-duty

days can be achieved and the individual

members of the nursing team will feel that

they are treated fairly. They will also knowtheir schedule in advance.

Scheduling


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A job description is a statement that sets

the duties and responsibilities of a specific

job. It includes the needed characteristics or

qualifications of the individual to performsuch duties successfully. It is an important

management tool to make certain that

responsibilities are wisely delegated, thatwork is efficiently distributed, that talents are

fully used, and morale is maintained.

Developing Job Description


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Principles of Organizing

Unity of Command

Scalar Principle or Hierarchy

Homogenous Assignment or Departmentation Span of Control

Exception Principle

Decentralization or Proper Delegation ofAuthority


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Although employees may interact

with many different employees in the

performance of their duties, they should be

responsible to only one superior. This is toavoid confusion, overlapping of duties and

misunderstanding.

Unity of Command


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Scalar Principle or Hierarchy

Authority and responsibility should flow in

clear unbroken lines from the highest

executive to the lowest. The other term for

this is chain ofcommand, usually a militaryterm.


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Homogenous Assignment or

Departmentation (Specialization)

Workers performing similar assignments

are grouped together for a common

purpose. Departmentation promotes the

specialization of activities, simplifies theadministrators work, and helps maintain

effective control.


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Exception Principle

Recurring decisions should be handled in a

routine manner by lower-level managers

whereas problems involving unusual matters

should be referred to the higher level.


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Decentralization or Proper Delegation

of Authority

Decentralization is the process of

conferring specified decision making to the

lower levels of the organization. Basic top

level decisions and policies must receiveattention at the top levels. The amount of

skills and competence of subordinates and

executives determines the success of anyprogram of decentralization.


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Executives should be developed to handle

situations delegated to them. This delegation

of authority is still subject to the supervision

and control of the delegating superior.


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-UMALI-


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Delmar LearningCopyright 2003 Delmar Learning, a Thomson Learning company

ORGANIZATIONAL

STRUCTURE

ORGANIZATIONAL REDESIGN,

RESTRUCTURING ANDREENGINEERING


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Delmar LearningCopyright 2003 Delmar Learning, a Thomson Learning company

RESTRUCTURING

A significant modification made to the debtoperations or structure of a company. This type of

corporate action is usually made when there are significantproblems in a company, which are causing some form offinancial harm and putting the overall business in jeopardy.The hope is that through restructuring, a company can

eliminate financial harm and improve the business.


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Chapter 9 Copyright 2003 Delmar Learning, aThomson Learning company

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REDESIGNING

make a design of; or a systematic planning

to change the design of (something).

Reorganize, Rearrange, Recast, Reshape


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REENGINEERING

Is the radical redesign of an organization's

processes, especially its business processes.

Rather than organizing a firm into functional

specialties (like production, accounting,marketing, etc.) and looking at the tasks that each

function performs.


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Restructuring and reengineering deals with the

entire organizations structure to improve its

functioning and productivity. It naturally follows organizational affiliations,

mergers, consolidations, and integrations.

Downsizing or right sizing by cutting thenumber of positions is also restructuring

requiring redesign.


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The role of the Nurse Manager through

3 Rs Involves: (Sullivan And Decker, 2001)

Team Building

Coaching

Mentoring Initiating change

Reducing cost

Improving quality of care


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Types of Organizational Structure

Informal Structure

Formal Structure

Pun Line Organization Line and Staff Organization

Functional Line and Staff Organization

Matrix or Free form Organization

Adhocracy or adaptive or organic model


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Purpose of Organizational Structure

The primary purpose of an organizational

structure is to facilitate the accomplishment of

the institutions mission.


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Informal Structure

It is based on personal relationship rather than

on respect for positional authority. It helps

member meet personal objectives and providesocial satisfaction.


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Formal Organization

The organizational structure furnishes the

formal framework in which the management

process takes place. It should provide an

effective work system, network ofcommunication, and identity to individuals

and the organization and should consequently

foster job satisfaction.


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Line and Staff Organization

Line and Staff Organization develops when a

simple line structure is altered to provide

support line authorities. The line functions are command and control.

The Staff functions are separate from chain of

command. Involves specialization, and asupportive to line authorities.


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Functions of Staff

Do what the executives do

Serve the line organization

Submerge personal interest to champion the

executives long range objectives.

Manages policies and procedures


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Functional Line and Staff Organization

Staff have some authority over line executive.

Staff expert responsible for specific

management function , such as staffing, staff

development , or quality improvement.

Has authority to command line executives to

implement staff plans.


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Matrix and Free Form Organization

Matrix organizational design try combine the

advantages of the project and the functional

structures.

The functional line organization provide supportfor the project line organization. The functional

manager has the authority to determine and rate

goals, select personnel, determine pay andpromotion, make personnel, and evaluate

personnel and the project.


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In a matrix organization the functional managershares those responsibilities with the projectmanager . Initially, the functional manager mayexperience a sense of loss in status, authority

and control.

Therefore it is important for the managers to be

able to persuade others by using their personalqualities and knowledge of the program.


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Characteristics of matrix

decision making as far down in theorganizational structure

Most decisions are made at the middle

management level More decentralized with fewer levels of

decision making

Increases the amount of contact amongindividuals & its complexity makes conflictinevitable.


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Adhocracy/ adaptive or Organic model

Adhocracy or organic models are newerorganizational frameworks that are more freeform, open , flexible and fluid than older

bureaucratic models. Boundaries separatinginternal & external relationships are moreeasily penetrated.

adhocracy comes from an ad hoc

committee.Its structures are looselystructured project organizations.


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-VIRAY-


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ORGANIZATIONAL CHART

Is a line drawing that shows how the parts of

an organization are linked. It depicts the

formal organizational relationships, areas of

responsibility, persons to whom one isaccountable and channels of communication.


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PURPOSES

They can contribute to sound organizational

structures

Show formal lines of communication

Help employees understand their

assignments, especially in relation to other.


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Organizational Concepts and

Structures


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Vertical Chart


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Horizontal Chart


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Circular Chart


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-JRO-


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LINE AND STAFF RELATIONSHIP

Line authority is the simplest and most direct type in

which each position has general authority over the

lower positions in the hierarchy in the

accomplishments of the main operations of the

organization. The unit head has direct responsibility

for the work of a unit.


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Staff personnel provides advice, counsel

or technical support that may be

accepted altered or rejected by the lineofficer.


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GUIDELINES IN ORGANIZING

1. Supply Market It is important that the local supplier capacity is

properly researched prior to organizing abusiness

seminar to ensure that goods and services arerelevant to the needs.

2. Invitations

The invitation should indicate the types ofsuppliers that will be attending the seminar.


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3. Frequency

Due to limited resources, and in order to befair to all countries, generally only

participate in one major supplier event per

country per year.

4. Facilities

The organizing entity should ensure that thefacilities are available for business

seminars:


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5. Agenda

The agenda for the business seminar should beagreed

with other participating organizations and theorganizing entity.

6. Individual meeting with suppliers

A program should be prepared in advance by the

organizing entity. Each supplier meetingshould be scheduled to last for no longer than 15minutes.


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7. Expenses

Organizing entities in developed countries areexpected to cover the travel expenses, hotel and

meals for all participants

8. Supplier fees

Any fees charged to suppliers for participating

should be kept to a minimum and aim to onlycover

costs incurred.


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9. Travel, Accommodation & other practicalinformation

The organizing entity is responsible for making the

necessary accommodation arrangements for

participants.


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-CHICO-


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Staffing


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Staffing

Is the process of determining

providing the acceptable number

mix of nursing personnel toproduce a

desired level of care to meet the patients

demand.


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Factors affecting staffing:

the type, philosophy, and objectives of thehospital and the nursing service;

the population served or the kind of patientsserved whether pay or charity;

the number of patients and severity of theirillness-knowledge and ability of nursingpersonnel are matched with the actual careneeds of patients;


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Factors affecting staffing cont

availability and characteristics of the nursing

staff, including education, level of preparation,

mix of personnel, number and position;

administrative policies such as rotation,

weekends and holiday off-duties;


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standards of care desired which should be

available and clearly spelled out. institution

may utilize the ANSAPs standard of nursing

practice; PRC-ANSAPs standards of safenursing practice and/ or the hospitals

themselves may formulate/develop their own

standards;


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availability and characteristics of the nursing

staff, including education, level of preparation,

mix of personnel, number and position;

administrative policies such as rotation,

weekends and holiday off-duties;


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expected hours of work per annum of each

employee. this is influenced by the 40-hour

week law; and

patterns of work schedule-traditional 5 daysper 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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layout of the various nursing units and

resources available within the department

such as adequate equipment, supplies, and

materials; budget including the amount allotted to

salaries, fringe benefits, supplies, materials,

and equipment;


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professional activities and priorities in

nonpatient activities like involvement in

professional organizations, formal educational

development, participation in research andstaff development;

teaching program or the extent of staff

involvement in teaching activities;


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expected hours of work per annum of each

employee. this is influenced by the 40-hour

week law; and

patterns of work schedule-traditional 5 daysper 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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Selection of personnel

Recruitment and Retention

Screening of potential staff

Interview

Orientation


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if a man proceeds confidently in the direction of

his dreams and endeavors to live the life he has

imagined, he will meet with success unexpected in

common hours------henry david Thoreau

The acquisition of qualified people in any agency

is critical for the establishment, maintenance andgrowth of the organizational. Therefore active

recruitment is important, and the attraction of

qualified applicants is the first step in selection of

personnel.


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Modes for active recruitment

employee recommendations and word of

mouth

advertisement in local newspaper, nursing

organization bulletins, and nursing journal

recruitment literature, such as fliers and

newsletter



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Modes for active recruitment cont

Posters

career days

job fairs

contract with schools graduating classes



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Modes for active recruitment cont

placement service

open houses

nursing conventions

Recruiters should know nursing qualificationsand the needs of the institution.



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Major sources of personnel

persons seeking their first jobs

dissatisfied employees

unemployed individuals

These classifications are important for all

categories indicate types of information the

nursing manager should obtain and they

influence the selection process.



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Interview

Orientation

S l i f l


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investment in well-qualified nurses can produce a

high rate of return and errors

whether they be failure to hire a promising nurse

or hiring someone who fails to achieve the

organizations expectations can be expensive mistaken.

Th h d l i


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There are three underlying

philosophy the screening process:

1. The manager should screen out applicants

who do not fit the agencys image.

2. The manager should try to fit the job to a

promising applicant.

3. Usually the manager should try to fit

applicant to the job.


li i f d


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Application forms and resumes

Data in the personal history educational

background, work experience, and other

pertinent informationcan be used to the

following:

determine whether the applicant meets minimal

hiring requirements, such as minimal educationallevel or minimal job experience


l f d


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Application forms and resumes cont

furnish background data useful in planning theselection interview

obtain names of references who may be

contracted for additional information about theapplicants work experience and general character

Collect information for personnel administration,

that is, social security number, number of

dependents, and so forth.


S l i f l


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Interview

Orientation

- A preemployment interview to predict job

success should be conducted with the most

qualified applicants.

S l i f l


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Interview

Orientation

P f h i i


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Purposes of the interview

to obtain information

to give information

to determine if the applicant meets the

requirements for the position

Interview


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One of the main purpose is to learn about theprospective employee.

The interview answers questions, explains

policies and procedures, and helps acquaint theapplicant with the position.

Finally, the interviewer must predict whether theapplicants overall performance will besatisfactory.

Interview

S l ti f l


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Interview

Orientation - Induction is the first 2 o 3 days oforientation. It can be done by

personnel department employees for

all new employees.

It i l d hi t f th


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It includes a history of the

organization

the vision

purpose

structure

working hours

holiday time

Vacation

sick time

paydays

performance standards

parking facilities

eating facilities

health services

education

opportunities

Orientation


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Orientation is important, and the manager whodoes not take the time to assist a new employee

is making a serious mistake.

Because of the information overload, induction

and further orientation should be conducted over

time. a checklist for orientation that indicates thecontent, time frame, and who is responsible to

teach it can be helpful.

Orientation


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-CRISTINA-

St ff d l t


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Staff development

Goes beyond orientation

It is a continuing liberal education of the

whole to develop her potential fully

It deals with aesthetic senses, as well as

technical and professional education

It is also related to retention, raises,

advancement to other positions ortermination

P t hi


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Preceptor ships

Used to help recruit, retain, orient, and developstaff.

Is responsible for the quality of patient care andfacilities the students learning.

They are liaison between students and theagency

They help students learn skills and learn how to

organize their work. A work shop to prepare preceptors is desirable.

Preceptor ships


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Preceptor ships

Purposes

Gives agency personnel an opportunity to

evaluate students and determine if they are

suitable candidates employment.

Mentorship


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Mentorship

Should provide an opportunity to shareinformation review works, provide feedback,explore issues, plan strategies and solveproblems.

Preceptors are role model who may becomementors.

Is a confident who personalizes role modelingand serve as a sounding board for decisions.

Are resource people who support thedevelopment of the younger person throughinfluences and promotion.

Mentorship


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Mentorship

Purposes

Gives their times, energy and materials

support teach, guide, assist, counsel and

inspire younger nurses.

Phases of the mentoring process


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Phases of the mentoring process

Invitation

Questioning

Transitional

Career mapping


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Career mapping

Is a strategic plan for ones career

It provides direction for formal education,

experience, continuing education, professional

association and network ship

Career mapping


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Career mapping

Purposes Nurses need to assess their own values and

define success for themselves

Job security , sense of accomplishment andopportunities for professional advancement areoften considered important

Other issues to considered are work hours,

salary, benefits retirements plans,organizational and geographical climate andlocation

Careers typically progress through


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stages:

Exploration (ages 15 to 22 yrs)

Early career(22 to 38 yrs)

Middle career (38 to 55 yrs)

Later career (55 to 70 yrs)


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-JENA-

ASSIGNMENT SYSTEM FOR STAFFING:


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ASSIGNMENT SYSTEM FOR STAFFING:

Changes in assignment systems are a responseto changing needs.

shortage of nurses

manage competition

care to patient through primary nursing

System Used in Staffing


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System Used in Staffing

Case Method Each patient is assigned to a nurse for total patient

care while that nurse is on duty.

Functional Nursing

Hierarchical structure predominant

Efficient system that is least costly and requiresfew RNs

Team Nursing


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Group or Team action

Led by a professional or Technical Nursewho:

Plan

Interprets Coordinates

Supervise

Evaluates Team member is encourage to make

suggestion and ideas


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Primary Nursing Patient should be the focus of professional nurses

instead of task

The RN remains responsible for the care of thepatient 24 hrs per day throughout the patient

hospitalization


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Modular or District Nursing Modification of Team and primary nursing

Uses smaller team who are grouped

geographically


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Managed Care Focused from acute care to promotion of health

and disease management of chronic and terminal

care


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Case Management Focused on chronic long term outpatient

(Psychiatry and social work)


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Collaborative Practice Interdisciplinary team

Nurse-physician interaction in practice or nurse-

physician collaboration on care giving

Advantages and Disadvantages of


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Assignment System

SYSTEM Advantages Disadvantages

Case

Method

Total patient

care

Different nurse,

different shifts,

different days


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Functional

Nursing

Efficiency Nurses do managerial

work

Nurses aides do

patient care

Time needed tocoordinate delegated

work.

SYSTEM Advantages Disadvantages


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Team

nursing

Team effort

Frees patient care

coordinator to manage

the unit

Nursing care

conferences help

problem solve and

develop staff

Nursing care plan

Time needed to

coordinate

delegated work


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Modular nursing Useful where

there are few RNs

RNs plan care

Paraprofessionals

do technical

aspects of care

Primary Nursing RNs give total patient care

Primary nurse has 24-hour

Confines nurses talents to

a limited number of


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y

responsibility

Associate nurse works

with patient while the

primary nurse is off duty

Accountability in place

Continuity of care is

facilitated

Reduces number of errors

from relay of orders

Fewer patient complaints

Shorter hospitalization

patients

Associates nurse may

change care plan without

discussing with primary

nurse

Managed Care Incorporates case Questionable


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management

Can be used with

any nursing care

deliver system

Standard critical

paths

Increases

efficiency

Reduces costs

continuity of care

Case Management Focuses on entire episode

of illness

Effort to coordinate


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Emphasizes achievement

of outcomesCare is coordinated by a

case manager

Second-generation

primary nursing

Critical paths

Variation analysis

Intershift reports

Health care team meeting

Interdisciplinary


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-ANJIING-


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Staffing Schedulesfor Productivity

Definition


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Definition

SCHEDULING

is the process of deciding how to commit

resources between a variety of possible tasks.

Time can be specified or floating as part of asequence of events.


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TYPES OF SCHEDULING:

Centralized Schedule- one person, usually the

chief nurse or her designate, assigns the

nursing personnel to the various units of thehospital. This includes the shifts on duty and

off-duty.


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Decentralized Schedule- the shift and off duties arearranged by the supervising nurse or head or senior

nurse of the particular unit.

Self Schedule- it is a system that is coordinated by

staff nurses.It is a process by which nurses and other

staff collectively develop and implement work

schedules, taking policies and variables affecting intoconsideration.


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-KAT-

Patient Care Classification System


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Patient Care Classification System

Is a method of grouping patients according tothe amount and complexity of their nursingcare requirements and the nursing time andskill they require.

This assessment can serve in determining theamount of nursing care required, generallywithin 24 hours, as well as the category of

nursing personnel who should provide thatcare.

LEVEL I


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LEVEL I

- Self Care or Minimal -

Patient can take a bath his own, feed himself,

feed and perform his activities of daily living.

LEVEL II


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- Moderate Care or Intermediate Care -

Patients under this level need some assistance

in bathing, feeding, or ambulating for shortperiods of time.

LEVEL III
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- Total, Complete or intensive Care -

Patient under this category are completely

dependent upon the nursing personnel.

LEVEL IV


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- Highly Specialized Critical Care -

Patients need maximum nursing care with

ratio of 80 professionals to 20 non-professionals.


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-BABY-

Republic Act 5901 The Fourty Hour Week Law


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Provides that employees working in thehospitals with 100 bed capacity and up willwork only 40 hours a week.

Employees working in agencies with less than100 bed capacity or in agencies located incommunities with less than one million

populations will work 48 hours a week andtherefore will get only one off- duty a week.

Civil Service Commission as per Memorandum Circular

No 6 series of 1996


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No.6, series of 1996

Granting of the three-day special privilege togovernment employees.

Which may be spent for Birthdays, weddings,anniversaries, funerals (mourning), relocation,

enrolment or graduation leave,

hospitalization, and accident leaves.

Rights and Privilegesgiven each personnel per

year

Working hours per week40hours

Working hours per week48 hours


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Vacation leave 15 15

Sick leave 15 15

Legal holidays 10 10

Specials holidays 2 2

Special privileges 3 3

Off

duties as per R.A.5901

104 52

Continuing education

program3 3

Total non-working days

per year

152 100

Total working holidays per

year213 265

Total working hours per

year1,704 2,120

SCHEDULED METHOD PROS CONS

SELF-SCHEDULING - coordinating by staff nurses

-saves manager scheduling time

-increases amount of time staff

spends on scheduling


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g g

-helps develop accountability

-increases perception of autonomy

-increased job satisfaction

-improved team spirit

-improved morale

-decreased absenteeism

-reduced turnover

-effective for recruitment and

retention

ROTATING WORK SHIFTS -can rotate teams -rotate among shifts

-increased stress

-affect health

-affect quality of work

Disrupt development of works group

-high turnover

PERMANENT SHIFTS -can participate in social activities-job

satisfaction-commitment to the

organization-few health problem-less

tardiness-less absenteeism-less

t

-most people want day shift-new

graduates predominantly staff

evening and nights-difficulty

evaluating evening and night shift-

t i t th


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turnover nurses may not appreciate the

workload or problems of other shift

BLOCK, OR CYCLICAL

SCHEDULING

-same schedule repeatedly-nurses

not so exhausted-sick time reduced-

personnel know schedule in social

events-decreased time spend on

scheduling-staff treated fairly-helps

establish stable work groups-

decreased floating-promotescontinuity of care

-rigidity

VARIABLES STAFFING -use census to determine number and

mix of staff-little need to call in

unscheduled staff

ALTERNATING OR ROTATING WORK SHIFTS


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The frequency of alternating between days and evening, ordays and nights, or rotating through all three shifts may varyamong institutions. Some nurses may work all three shiftswithin 7 days.

Alternating and rotating work shift create stress for staffnurses, environmental cues, such as: sunrise and sunset,fluctuate in a predictable cycle.


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Instrument s that designate hours, minute, and seconds correspond to thenatural daily cycle and allow knowledge of ones location in that cycle.

The ability of the body function to adjust varies considerably among

individuals; it takes 2 to 3 days to 2 weeks for a person to adjust to a

different sleep-awake cycle.

PERMANENT SHIFTS


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Permanent shifts relieve nurses from stressand health-related problem associated with

alternating and rotating shift.

When nurses are able to choose the shift thatbest suits their personal life, they can

participate in social activities, even when they

require regular attendance.


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In studies conducted with MONTREALNURSES, those working permanent shifts had

higher average on psychological scales such

as: mental health, job satisfaction, socialinvolvement, and commitment to the

organization.

BLOCK OR CYCLICAL SCHEDULING


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Uses the same schedule repeatedly. With a 6-day forward rotation, personnel are scheduled

to work6 successive days followed by at least

2 days off. The scheduled repeats it every 6weeks.


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Personnel can be scheduled with every otherweekend off and 1 day during the week so

that there are more than 4 consecutive days

of are not exhausted by working too manyconsecutive days, sick leave can be reduced.

TEN HOURS PER DAY, FOUR-DAY WORK

PER WEEK


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PER WEEK

A cyclical scheduled allowed at least 14 hoursoff between shifts and a 4-day weekend every

6 weeks for those who rotated.

The work week began on Sunday and theweekend was Saturday and Sundays for all

shifts.

Variables staffing PROS CONS

8 hours Traditional


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10 hours Time to complete work,

Long weekends,

Extra days off,

Decreased overtime,

Cover peak workloads,

Decreased costs

Longer workday,

Fatigue,

Overlap,

Difficult to find substitute

12 HOURS Lower staffing requirements,Lower

cost per patient day,Increased

knowledge of patients,Get new

admission settled,Not so

rushed,Better continuity of care,Team

development is possible,Less daily to

do staffing,Reduced travel time,Less

personal expenses for gas, meals,

babysitting

Overtime,Exhaustion increases at

end of workweek,Tension increased

at the end of workweek,Increased in

minor accident,Increased medication

errors,Home and social life suffer the

week worked.


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-JOSEPH-

Determination of Number of Nursing

Personnel


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Personnel

Importance: So that there should have sufficient staff to

cover all shifts, off-duties, holidays, leaves,

absences, and time for staff developmentprogram.


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Steps inComputing Number

of NursingPersonnel

Sample Problem


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Find the number of nursing personnel neededfor 250 patients in tertiary hospital.

Eh.. Panu bhe eyun??

Toxic yata??

Illustration:


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Step 1

Categorize the patients according to the levels ofcare needed.

Multiply the total number of patients by the

percentage of patients at each level of care.

250(pts)

250(pts)

250(pts)250(pts)

x .30

x .45

x .15x .10

=75 min. care

= 112.5 mod.care

= 37.5 int. care= 25 h. spcl. care

250

GIVEN

Step 2

Fi d h # f P h l l b h b


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Find the # of Pts at each level by the average number

of nursing care hour needed per day.

Get the sum of the NCH/day needed at the various

levels.

75pts

112.5pts

37.5pts

25pts

x 1.5 (NCH@L1)

x 3 (NCH@L2)

x 4.5 (NCH@L3)

x 6 (NCH@L4)

= 112.5NCH/day

= 337.5 NCH/day

= 168.75 NCH/day

= 150NCH/day

768.75NCH/dayTotal

=75 min. care

= 112.5 mod.care

= 37.5 int. care

= 25 h. spcl. care

Step 3

Fi d th t l b f i h d d b th


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x 365 days/year

280,593.75 NCH/year

Find the actual number of nursing care hours needed by the

given number of patients.

Multiply the total nursing care hours needed per day by the

total number of days in a year.

768.75NCH/day

SAVE

Step 4

Fi d th t l b f ki h d d b h


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8 (hrs/day)

213 (working days/year)

1,704 working hours/year

Find the actual number of working hours rendered by each

nursing personnel per year.

Multiply the number of hours on duty per day by the actual

working days per year.

SAVE280,593.75 NCH/year

x

SAVE

Total NCH/yrWorking hrs/yr

Step 5

Divide the total # of NCH/yr by the actual # of working hrs


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Total NCH/yr =

Working hrs/yr

Relief x Total Nsg Personnel =

Total Nursing Personnel needed

Divide the total # of NCH/yr by the actual # of working hrsrendered by an employee/yr.

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 thoseworking 48 hours per week).

Add the number of relievers to the number of nursing

personnel needed.

SAVE

280,593.75 =

1,704

165

x 0.15 = 25

+ =190SAVE1,704 working hours/year 280,593.75 NCH/year

Step 6

Categorize the nursing personnel into professionals and non


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Categorize the nursing personnel into professionals and non-

professionals.

Multiply the # of nsg personnel according to the ratio of

professionals to non-professionals

190

190

x .65 =

x .35 =

124 professional nurses

66 nursing attendants

Step 7

Distribute by shifts


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Professional

124 nurses

124 nurses124 nurses

Distribute by shifts.

124 professional nurses66 nursing attendants

x .45

x .37x . 18

= 56 nurses on AM shift

= 46 nurses on PM shift= 22 nurses on night shift

total 124 nurses

Step 7

Distribute by shifts


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Non-Professional

66 Nsg attendant

66 Nsg attendant

66 Nsg attendant

Distribute by shifts.

66 nursing attendants 124 professional nurses

x .45

x .37

x .18

total 66 Nsg attendant

= 30 Nsg attendant on AM shift

= 24 Nsg attendant on PM shift

= 12 Nsg attendant on night shift


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Tapos na!

25474360 nursing leadership

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