Patient Acuity, Workload and FTE's
2 years ago 5
2023_SpreadsheetforWeek3_DQ3.4.xlsx
Week3.4DiscussionPatientAcuityWorkloadandFTEs.docx
Ch11Staffing.pptx
2023_SpreadsheetforWeek3_DQ3.4.xlsx
Week3.4DiscussionPatientAcuityWorkloadandFTEs.docx
Week 3 DQ 3.4
3.4 DiscussionPatient Acuity, Workload and FTE's
After reading Chapter 11: Staffing and Scheduling, answer the discussion question.
Nurses work within the constraints of the situation. Staffing, budget, day of the week, number of patients, and situations on the unit among many others. Nurse managers also have constraints today due to limited staffing, staff mix, patient: nurse ratios, etc. Managers - and often charge nurses too -- have to make unit decisions for a shift based on the constraints given to them and the best possible outcomes for the patients and staff. Is it easy, no way!
This exercise places you in a fictitious nursing unit with constraints. This is NOT your unit or any unit you know. Your work situation does NOT apply to the scenario below. Please work through the discussion and spreadsheet to the best of your ability to work within the unit's constraints. Put your thinking cap on! See how to best solve the puzzle!
· First, watch the video made for this assignment BEFORE beginning the assignment.
· This assignment does not apply to your unit, where you work, or your own personal working conditions.
· The situation in this exercise is intended as a critical thinking exercise for you to demonstrate your ability to work through a difficult situation.
· Do NOT apply anything from your personal working unit to this scenario unit. Do not include your personal working conditions in the answer to this discussion question.
· Please follow the instructions and experience the constraints that nurse managers typically work within.
· You will be using a Microsoft Excel spreadsheet in this discussion. You only can change the cells in the spreadsheet that are "unlocked" for your use. Some cells have a red flag in their upper right corner - click on the cell and you will see a pop-up box with information.
Approved Resources to Use in Writing Discussion Posts:
· The course textbook,
· any published peer-reviewed full-text article from the CINAHL database
For your initial post, complete the following:
Next, find, open, and read the Excel spreadsheet document that goes with this discussion question. Complete the spreadsheet and attach it to your post. Then, return to the discussion question. Prepare a minimum of a 200-word response using the instructions and the scoring rubric.
|
In your post, answer the following questions |
|
|
Question 1: |
Describe the process of creating your own staffing positions and 2-week schedule. If the acuity or average daily census on your unit goes up during a year's time, and your budget plan does not include an increase in acuity levels or an increase in census, what will you need to do as a leader and manager in this organization? |
|
Question 2: |
If the acuity at your facility goes DOWN during a year's time, and your budget plan does not include direction for a decreased census, what will you need to do as a nursing leader/manager? |
Response Posts
Ch11Staffing.pptx
Chapter 11
Staffing and Scheduling
1
Learning Outcomes (1 of 2)
Integrate current research into principles to effectively manage nurse staffing.
Use technology to plan, implement, and evaluate staffing, scheduling, and the effectiveness of a unit’s productivity.
Examine personnel scheduling needs in relation to patients’ requirements for continuity of care and positive outcomes, as well as the nurse manager’s need to create a schedule that is fair and equitable for all team members.
2
2
Learning Outcomes (2 of 2)
Evaluate the effects of floating, mandatory overtime, and the use of supplemental agency staff to nurse satisfaction and patient care outcomes.
Evaluate the impact of patient and hospital factors, nurse characteristics, nurse staffing, and other organizational factors that influence nurse and patient outcomes.
3
3
Introduction
Staffing
Scheduling
4
The Staffing Process (1 of 2)
Fixed staffing models
Flexible staffing
Centralized staffing
Decentralized staffing
5
The Staffing Process (2 of 2)
Developing a Staffing Budget
Calculation of Full-Time Equivalents
Impact of Staffing on Patient Outcomes
Theoretical Framework for Nursing Staffing
Models for Nurse Staffing
Nurse–Patient Ratios
Alternative to the Nurse–Patient Ratio Staffing
Tools to Estimate the Number of Nurses Needed
6
Developing a Staffing Budget
Forecast workload to calculate number of FTE (full-time equivalents)
Productive time
Direct care hours
Indirect care hours
Benefit time
7
Calculation of Full-Time Equivalents
Distribution of the FTEs
Based on budget
Includes the following:
Hours of operation of unit
Basic shift length
Activity patterns for unit
Shift rotation
Weekend requirements
Personal and professional requirements
8
Factors in Staffing that Influence Patient Outcomes
Education
Overtime
Agency/float Pools
9
Nurse-Patient Ratio
Requires set number of patients cared for by one nurse.
Mandated nurse-patient ratios.
Some state have legislation for this staffing.
10
Alternative to Nurse-Patient Ratio Staffing
ANA opted to support nurse staffing committee.
Safe staffing principles
Based on:
RN educational level
RN certifications
RN level of experience
Number of healthcare personnel
Geography of unit
Technology
Intensity, complexity, and stability of patients
11
Patient Classification Systems
Acuity
Severity of patients’ conditions multifactorial
Patient classification types
Prototype evaluation system
Factor evaluation system
12
Budget-Based Staffing
Staffing developed with budget plan
Based on the Nursing Hours Per Patient Day (HPPD)
Direct care vs Indirect care
13
Complex Factors in Health Care Influencing Patient Outcomes
Missed Care
Hospital-acquired conditions
14
National Database of Nursing Quality Indicators
One component in evaluating effectiveness of staffing process
NDNQI opportunity to compare effectiveness in specific nursing service unit
Comprehensive national nursing database
18 Quality indicators to use for benchmarking
Nurse-sensitive data
15
Nurse Overtime
Mandatory Overtime
Require staff to stay after their shift to fill vacancies
Prohibited by some states
Overtime
Not required
16
Supplemental Staff and Float Pools
Organizations may use supplemental staff to fill temporary staff vacancies
Nurses may be used to fill unanticipated staff vacancies which involves “floating” from one clinical unit to another
17
Organizational Factors that Affect Staffing Plans
Structure and Philosophy of the Nursing Services Department
Organizational support systems
Services offered
18
Scheduling
Distribution of the FTEs
Based on budget
Includes the following:
Hours of operation of unit
Basic shift length
Activity patterns for unit
Shift rotation
Weekend requirements
Personal and professional requirements
19
Constructing the Schedule
Function of the staffing plan
Assigning days to personnel to work
Developed 1 to 3 months in advance
Constructed based on unit/facility policy
20
Schedule Development Methods
Decentralized scheduling
Staff self-scheduling
Centralized scheduling
21
Variable Affecting Staffing Schedules
Hours of operation
Shift rotations
Weekend rotations
Approved benefit time for the schedule period
Approved leaves of absence/short-term disability
Approved seminar, orientation, and continuing education time
Scheduled meetings for the schedule period
Current filled positions and current staffing vacancies
Number of part-time employees
22
Evaluating Unit Staffing and Productivity
Managers must justify staffing
Provide productivity reports
Average daily census projects potential workload
Percentage of occupancy
Average length of stay
Nursing productivity
23
Conclusion
Satisfaction of staff important
Patient outcomes important
Collaborative between manager and staff
Must meet needs
24
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2023_SpreadsheetforWeek3_DQ3.4.xlsx
Week3.4DiscussionPatientAcuityWorkloadandFTEs.docx
Week 3 DQ 3.4
3.4 DiscussionPatient Acuity, Workload and FTE's
After reading Chapter 11: Staffing and Scheduling, answer the discussion question.
Nurses work within the constraints of the situation. Staffing, budget, day of the week, number of patients, and situations on the unit among many others. Nurse managers also have constraints today due to limited staffing, staff mix, patient: nurse ratios, etc. Managers - and often charge nurses too -- have to make unit decisions for a shift based on the constraints given to them and the best possible outcomes for the patients and staff. Is it easy, no way!
This exercise places you in a fictitious nursing unit with constraints. This is NOT your unit or any unit you know. Your work situation does NOT apply to the scenario below. Please work through the discussion and spreadsheet to the best of your ability to work within the unit's constraints. Put your thinking cap on! See how to best solve the puzzle!
· First, watch the video made for this assignment BEFORE beginning the assignment.
· This assignment does not apply to your unit, where you work, or your own personal working conditions.
· The situation in this exercise is intended as a critical thinking exercise for you to demonstrate your ability to work through a difficult situation.
· Do NOT apply anything from your personal working unit to this scenario unit. Do not include your personal working conditions in the answer to this discussion question.
· Please follow the instructions and experience the constraints that nurse managers typically work within.
· You will be using a Microsoft Excel spreadsheet in this discussion. You only can change the cells in the spreadsheet that are "unlocked" for your use. Some cells have a red flag in their upper right corner - click on the cell and you will see a pop-up box with information.
Approved Resources to Use in Writing Discussion Posts:
· The course textbook,
· any published peer-reviewed full-text article from the CINAHL database
For your initial post, complete the following:
Next, find, open, and read the Excel spreadsheet document that goes with this discussion question. Complete the spreadsheet and attach it to your post. Then, return to the discussion question. Prepare a minimum of a 200-word response using the instructions and the scoring rubric.
|
In your post, answer the following questions |
|
|
Question 1: |
Describe the process of creating your own staffing positions and 2-week schedule. If the acuity or average daily census on your unit goes up during a year's time, and your budget plan does not include an increase in acuity levels or an increase in census, what will you need to do as a leader and manager in this organization? |
|
Question 2: |
If the acuity at your facility goes DOWN during a year's time, and your budget plan does not include direction for a decreased census, what will you need to do as a nursing leader/manager? |
Response Posts
Ch11Staffing.pptx
Chapter 11
Staffing and Scheduling
1
Learning Outcomes (1 of 2)
Integrate current research into principles to effectively manage nurse staffing.
Use technology to plan, implement, and evaluate staffing, scheduling, and the effectiveness of a unit’s productivity.
Examine personnel scheduling needs in relation to patients’ requirements for continuity of care and positive outcomes, as well as the nurse manager’s need to create a schedule that is fair and equitable for all team members.
2
2
Learning Outcomes (2 of 2)
Evaluate the effects of floating, mandatory overtime, and the use of supplemental agency staff to nurse satisfaction and patient care outcomes.
Evaluate the impact of patient and hospital factors, nurse characteristics, nurse staffing, and other organizational factors that influence nurse and patient outcomes.
3
3
Introduction
Staffing
Scheduling
4
The Staffing Process (1 of 2)
Fixed staffing models
Flexible staffing
Centralized staffing
Decentralized staffing
5
The Staffing Process (2 of 2)
Developing a Staffing Budget
Calculation of Full-Time Equivalents
Impact of Staffing on Patient Outcomes
Theoretical Framework for Nursing Staffing
Models for Nurse Staffing
Nurse–Patient Ratios
Alternative to the Nurse–Patient Ratio Staffing
Tools to Estimate the Number of Nurses Needed
6
Developing a Staffing Budget
Forecast workload to calculate number of FTE (full-time equivalents)
Productive time
Direct care hours
Indirect care hours
Benefit time
7
Calculation of Full-Time Equivalents
Distribution of the FTEs
Based on budget
Includes the following:
Hours of operation of unit
Basic shift length
Activity patterns for unit
Shift rotation
Weekend requirements
Personal and professional requirements
8
Factors in Staffing that Influence Patient Outcomes
Education
Overtime
Agency/float Pools
9
Nurse-Patient Ratio
Requires set number of patients cared for by one nurse.
Mandated nurse-patient ratios.
Some state have legislation for this staffing.
10
Alternative to Nurse-Patient Ratio Staffing
ANA opted to support nurse staffing committee.
Safe staffing principles
Based on:
RN educational level
RN certifications
RN level of experience
Number of healthcare personnel
Geography of unit
Technology
Intensity, complexity, and stability of patients
11
Patient Classification Systems
Acuity
Severity of patients’ conditions multifactorial
Patient classification types
Prototype evaluation system
Factor evaluation system
12
Budget-Based Staffing
Staffing developed with budget plan
Based on the Nursing Hours Per Patient Day (HPPD)
Direct care vs Indirect care
13
Complex Factors in Health Care Influencing Patient Outcomes
Missed Care
Hospital-acquired conditions
14
National Database of Nursing Quality Indicators
One component in evaluating effectiveness of staffing process
NDNQI opportunity to compare effectiveness in specific nursing service unit
Comprehensive national nursing database
18 Quality indicators to use for benchmarking
Nurse-sensitive data
15
Nurse Overtime
Mandatory Overtime
Require staff to stay after their shift to fill vacancies
Prohibited by some states
Overtime
Not required
16
Supplemental Staff and Float Pools
Organizations may use supplemental staff to fill temporary staff vacancies
Nurses may be used to fill unanticipated staff vacancies which involves “floating” from one clinical unit to another
17
Organizational Factors that Affect Staffing Plans
Structure and Philosophy of the Nursing Services Department
Organizational support systems
Services offered
18
Scheduling
Distribution of the FTEs
Based on budget
Includes the following:
Hours of operation of unit
Basic shift length
Activity patterns for unit
Shift rotation
Weekend requirements
Personal and professional requirements
19
Constructing the Schedule
Function of the staffing plan
Assigning days to personnel to work
Developed 1 to 3 months in advance
Constructed based on unit/facility policy
20
Schedule Development Methods
Decentralized scheduling
Staff self-scheduling
Centralized scheduling
21
Variable Affecting Staffing Schedules
Hours of operation
Shift rotations
Weekend rotations
Approved benefit time for the schedule period
Approved leaves of absence/short-term disability
Approved seminar, orientation, and continuing education time
Scheduled meetings for the schedule period
Current filled positions and current staffing vacancies
Number of part-time employees
22
Evaluating Unit Staffing and Productivity
Managers must justify staffing
Provide productivity reports
Average daily census projects potential workload
Percentage of occupancy
Average length of stay
Nursing productivity
23
Conclusion
Satisfaction of staff important
Patient outcomes important
Collaborative between manager and staff
Must meet needs
24
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