Computation on a 100-Bed Capacity Tertiary Hospital on Staff and Levels of Care
I.
Determine the Staff Needed
Staffing is the process of developing and maintaining staffing patterns and assignin assigning g compete competent nt people people to fill the roles roles designa designated ted for the organiza organization tion structures through recruitment, selection, and development of personnel. Tabl Table e 1. 1.
Numb Number er of Nurs Nursin ing g Car Care e Hou Hours rs Need Needed ed Per Per Pat Patie ient nt Per Per Day Day Per Levels of Care Levels of Care Number of Nursing Care Hours Needed Per Patient Per Day Level I – Minimal Care 1.5 Level II - Intermediate 3.0 Level III – Intensive Care 4.5
II.
Patient Cl Classification Sy System
It is a system for identifying the nursing care needs of patients by category or is a method for grouping patients according to the amount and complexity of nursing care requirements over a period of time. It is a means of categorizing patients on the basis of certain needs that can be clinically clinically observed observed by the nurse. nurse. Patient Patient classifi classificati cation on systems systems were were introduced as a basis for staffing planning when it was recognized that patient’s differing needs for care are more the result of different dependency needs than of different diagnosis. Four Category Classification System: 1.
SelfSelf-Ca Care re or Mini Minimal mal Care Care (Level (Level I) – are capa capable ble or carryi carrying ng out out acti activi viti ties es of dail daily y livi living ng as long long as the the nurs nurses es prov provid ides es nece necess ssar ary y equipment and supplies such as meal trays, bed linen, medications and dressing materials and performs care planning and discharge planning on the patient’s behalf.
2.
Intermediate or Moderate or Partial Care (Level II) – maybe able to feed, bathe, toilet, and dress himself without help, but requires some help from from the nursin nursing g staff staff with with specia speciall treat treatme ment nts s or certa certain in aspec aspects ts of personal personal care. For example, example, a partial patient care care might require wound wound debridement or dressing, catheterization, colostomy irrigation, intravenous
fluid therapy, intramuscular physiotherapy.
injection,
or chest
3.
Bed Ridden Patient (Level III) – lacks strength or mobility necessitates nursing assistance with all activities of daily living such as feeding, bathing, dressing, moving, positioning, eliminating, comfort seeking, and injury avoidance can be said to require total care.
4.
Acute or Critically ill (Level IV) – is in constant danger of death or serious injury without immediate and skillful intervention to avert threat and adjust treatment can be said to require intensive care.
Table 2.
The Ratio of Professional Nurse to Non-Professional Nursing Personnel in Various Levels of Care. Levels of Care
Level I – Minimal Care Patients Level II – Intermediate or Moderate Care Patients Level III – Intensive Care Patients Level IV – Highly Specialized Intensive Care Patients
Table 3.
Ratio of Professional to Non-Professionals 55- 45 60 - 40 65 – 35 70 – 30 or 80 - 20
Percentage of Patients in Various Level of Care per Type of Hospital
Type of Hospital Primary Hospital Secondary Hospital Tertiary Hospital Special Tertiary Hospital II.
or subcutaneous
Percentage of Patients in Various Level of Care Minimal Care Moderate Care Intensive Care 70 25 5 65 30 5 35 45 20 25 40 35
Determining the Number of Nursing Personnel Needed
The number of nursing personnel to staff the various units/departments should be sufficient to cover the service even when part of the personnel are offduty, absent or are on vacation or sick leave, or on legal holiday off.
Table 4. Total Number of Working Days, Non-Working Days and Working Hours of Nursing Personnel Per Year. Rights/Privileges Given Each Personnel 1. Days of Vacation Leave 2. Days of Sick Leave 3. Legal Holidays 4. Special Holidays 5. Continuing Education 6. Off Duties R.A. 5901 Total non-working days/year Total working days/year Total working hours/year
Working Hours Per Week 40 hrs 15 15 10 2 3 104 149 216 1,728
48 hrs 15 15 10 2 3 52 97 268 2,144
Those working 48 hours per week will have a total of 97 non-working days, 268 working days, and 2,144 working hours per year. Those working 40 hours per week will have more off-duties, less working days and hours per year. These will be 149 non-working days; 216 working days and 1,728 working hours per year. III.
Relievers Needed
Each employee has an average number of ten (10) days vacation leave and five (5) days sick leave per year. They also enjoy the twelve (12) days holiday off and three (3) days for attending continuing education programs. Their total average of absences is thirty (30) days per year. To compute for the total relievers needed multiply the computed number of nursing personnel by 30 and divide by the actual number of working days (216 or 268) depending on whether they work 5 or 6 days a week. With these data on hand it is now possible to compute the number of nursing personnel on a yearly basis utilizing the data earlier given and the percentage of patients in various levels of care. IV.
Distribution by Shifts
Studies have shown that the morning shift needs the most number of nursing personnel 45%, the afternoon shift needs about 37%, and the night shift need only about 18% because more nursing care are given during the morning and afternoon shifts than those during the nights shifts.
Formula for Computing the Number of Staff Needed in the In-Patient Areas of the Hospital. Step 1:
Categorize Patients According to Levels of Care
100 patients x .65 = 65 patients needing minimal care 100 patients x .30 = 30 patients needing moderate/intermediate care 100 patients x .05 = 5 patients needing intensive care Step 2: Find the Number of Nursing Care Hours (NCH) Needed by Patient per Day at Each Categorized Level 65 x 1.5 (NCH needed/day at level 1) = 97.5 NCH needed by 65 patients 30 x 3
(NCH needed/day at level 2) = 90
NCH needed by 30 patients
5 x 4.5 (NCH needed/day at level 3) = 22.5 NCH needed by 5 patients __________ Total = 210 Nursing Care Hours Per Day Step 3: Find the Actual Number of Nursing Care Hours Needed by 100 Patients per Year. 210 x 365 = 76,650 total NCH needed per year Step 4:
Find the Number of Nursing Personnel Needed
a.
76,650 (NCH per year) = 44 Nursing Personnel 1728 (working hrs/yr)
b.
44 x 30 = 1320 = 6 Nursing Personnel as Relief 216 216
c.
44 + 6 = 50 Total Nursing Personnel Needed
Step 5:
Categorize into Professional and Non-Professional
50 x .60 = 30 Nurses
50 x .40 = 20 Nursing Attendants
Step 6:
Distribute by Shifts
30 x .45 = 14 Nurses on 7 – 3 shift 30 x .37 = 11 Nurses on 3 – 11 shift 30 x .18 = 5 Nurses on 11 – 7 shift _ Total = 30 Nurses
20 x .45 = 9 Nursing Attendants on 7 – 3 shift 20 x .37 = 7 Nursing Attendants on 3 – 11 shift 20 x .18 = 4 Nursing Attendants on 11 – 7 shift Total = 20 Nursing Attendants
