report of bsn 4c2 ncm 105

8/14/2019 Report of Bsn 4c2 Ncm 105

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UNIVERSITY OF REGINA CARMELICatmon, City of Malolos

ORGANIZING&

STAFFING

Submitted by:Arceo, Joanna Rose S.

Chico, Jenelyn L.De Leon, Joseph Rommel B.Evangelista, Jenalyn M.Mendoza, Angelica D.

Robles, Lady Anthea T.Santos, Baby Richelle S.

Surban, Katrina D.Umali, Joemar T.Viray, Regina B.

BSN 4C-2

Submitted to:


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Rosalina Punzalan RN

January, 2010

ORGANIZING

Organization consists of the structure and process which allow the agencyto enact its philosophy and utilize its conceptual framework to achieve its goals. Itrefers to a body of persons, methods, policies and procedures arranged in asystematic process through the delegation of functions and responsibilities for the accomplishment of purpose.

Organizing is the process of establishing formal authority. It involvessetting up the organizational structure through identification of groupings, rolesand relationships, determining the staff needed by developing and maintainingstaffing patterns and distributing them in various areas as needed. It includesdeveloping job descriptions by defining the qualifications and functions of personnel.

An organizational chart is a line drawing that shows how the parts of anorganization are linked. It depicts the formal organizational relationships, areas of responsibility, persons to whom one is accountable and channels of communication.

Elements of Organizational Structure

Setting up the Organizational Structure

The creation of an organizational compatible system with the philosophy,conceptual framework, and goals of the organization provides the means for theaccomplishment of an organizations purpose.

Understanding the organizational structure as a whole facilitates thedevelopment of roles and relationships to enable the achievement of goals. Theorganizational structure refers to the process by which a group is formed, itschannel of authority, span of control and lines of communication.Departmentalization and division of work provide orderliness in administration.Through a breakdown of activities each individual becomes responsible for aspecified set of activities and performs such.

The successful setting up of the organizational structure enables an organizationto achieve its purposes:

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

1. It allows the manager and the individual workers to concentrate on his/her specific role and responsibilities.

2. It coordinates all organizational activities so there is minimal duplication of

effort and conflict3. It reduces the chances of doubt and confusion concerning assignments.4. It avoids overlapping of functions because it pinpoints responsibilities.5. It shows to whom and for whom they are responsible.

The organizational structure of the Nursing Service should be updated,reviewed, approved and documented by the proper authority. Date of last reviewshould be documented.

Staffing

The process of determining and providing the acceptable number and mixof nursing personnel to produced a desired level of care to meet patientsdemand.

The purpose of all staffing activities is to provide each nursing unit with anappropriate and acceptable number of workers in each category to perform thenursing tasks required. Too few or an improper mixture of nursing personnel willadversely affect the quality and quantity of work performed. Such situation canlead to high rates of absenteeism and staff turn-over resulting in low morale anddissatisfaction.

SchedulingA schedule is a timetable showing planned work days and shifts for

nursing personnel.

The objective in scheduling is to assign working days and days off to thenursing personnel so that adequate patient care is assured. A desirabledistribution of off-duty days can be achieved and the individual members of thenursing team will feel that they are treated fairly. They will also know their schedule in advance.

Developing Job DescriptionA job description is a statement that sets the duties and responsibilities

of a specific job. It includes the needed characteristics or qualifications of theindividual to perform such duties successfully. It is an important management toolto make certain that responsibilities are wisely delegated, that work is efficientlydistributed, that talents are fully used, and morale is maintained.

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Principles of Organizing

In designing the organizational structure of the nursing department /service / division, certain organizational principles must be observed.

1.Unity of Command although employees may interact with many differentemployees in the performance of their duties, they should be responsibleto only one superior. This is to avoid confusion, overlapping of duties andmisunderstanding.

2. Scalar Principle or Hierarchy authority and responsibility should flow inclear unbroken lines from the highest executive to the lowest. The other term for this is chain of command, usually a military term. Proper definition and delegation of authority and responsibility facilitate theaccomplishment of work. In this connection, the following must beobserved:

a. When responsibility for a particular job is delegated to a

subordinate, the latter should have authority over resources neededto accomplish the task;b. When a particular function is delegated to a subordinate, the

superiors own responsibility is in no way diminished; andc. When a person is bestowed the authority for action, he is

accountable for his actions to the person that bestowed him such.The conscientious nurse exhibits accountability toward her employing hospital, the patient, the government, her profession,and to God.

3. Homogenous Assignment or Departmentation - 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.4. Span of Control the number of workers that a supervisor can effectively

manage should be limited, depending upon the pace and pattern of theworking area. it also refers to span of managerial responsibility and thenumber which one supervisor can assist, teach and help to reach theobjectives of their own jobs. If the workers are highly skilled and areworking near each other, their number may be increased. At the top levelof the structure, a 1:6 ratio of supervisor-worker is common, while at thebase of the organization, a 1:10 ratio is common.

5. Exception Principle Recurring decisions should be handled in a routinemanner by lower-level managers whereas problems involving unusualmatters should be referred to the higher level. This will enablesubordinates to learn how to make decisions at their own level and freeexecutives from being bogged down by routine details that can be handledas well by subordinates.

6. Decentralization or Proper Delegation of Authority Decentralization is theprocess of conferring specified decision making to the lower levels of theorganization. Basic top level decisions and policies must receive attention

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at the top levels. The amount of skills and competence of subordinatesand executives determines the success of any program of decentralization. Executives should be developed to handle situationsdelegated to them. This delegation of authority is still subject to thesupervision and control of the delegating superior.

Distribution of necessary information about critical issues is vital to anydelegation process. An executive should have sufficient

Prepared by: Robles, Lady Anthea***

ORGANIZATIONAL STRUCTURE

RESTRUCTURING

A significant modification made to the debt operations or structureof a company. This type of corporate action is usually made whenthere are significant problems in a company, which are causingsome form of financial harm and putting the overall business in

jeopardy. The hope is that through restructuring, a company caneliminate financial harm and improve the business.

REDESIGNING

make a design of; or a systematic planning to change the design of (something). Reorganize, Rearrange, Recast, Reshape

REENGINEERING

Is the radical redesign of an organization's processes, especially itsbusiness processes. Rather than organizing a firm into functionalspecialties (like production, accounting, marketing, etc.) and lookingat the tasks that each function performs.

Restructuring and reengineering deals with the entire organizationsstructure to improve its functioning and productivity.

It naturally follows organizational affiliations, mergers, consolidations, andintegrations. Downsizing or right sizing by cutting the number of positionsis also restructuring requiring redesign.

The role of the Nurse Manager through 3 Rs Involves: (Sullivan And Decker,2001)

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Team Building Coaching Mentoring Initiating change Reducing cost

Improving quality of carePurpose of Organizational Structure The primary purpose of an organizational structure is to facilitate the

accomplishment of the institutions mission.

Types of Organizational Structure

1. Informal Structure It is based on personal relationship rather than on respect for

positional authority. It helps member meet personal objectives and

provide social satisfaction.2. Formal Structure

The organizational structure furnishes the formal framework inwhich the management process takes place. It should provide aneffective work system, network of communication, and identity toindividuals and the organization and should consequently foster jobsatisfaction.

3. Pun Line Organization

4. Line and Staff Organization Line and Staff Organization develops when a simple line structureis 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 a supportive to line authorities.

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

5. 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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6. Matrix or Free form Organization Matrix organizational design try combine the advantages of the

project and the functional structures.The functional line organization provide support for the project line

organization. The functional manager has the authority to determine andrate goals, select personnel, determine pay and promotion, makepersonnel, and evaluate personnel and the project.

In a matrix organization the functional manager shares thoseresponsibilities with the project manager . Initially, the functionalmanager may experience a sense of loss in status, authority andcontrol.

Therefore it is important for the managers to be able to persuadeothers by using their personal qualities and knowledge of theprogram.

Characteristics of matrix decision making as far down in the organizational structure Most decisions are made at the middle management level More decentralized with fewer levels of decision making Increases the amount of contact among individuals & its

complexity makes conflict inevitable.

7. Adhocracy or adaptive or organic model Adhocracy or organic models are newer organizational frameworks

that are more free form, open, flexible and fluid than older

bureaucratic models. Boundaries separating internal & externalrelationships are more easily penetrated. Adhocracy comes from an ad hoc committee. Its structures are

loosely structured project organizations.

Prepared by: Umali, Joemar

***

ORGANIZATIONAL CHART

Is a line drawing that shows how the parts of an organization are linked. Itdepicts the formal organizational relationships, areas of responsibility, persons towhom one is accountable and channels of communication.

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

Figure 1 Vertical Chart

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Figure 2 Horizontal Chart

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Figure 3 Circular Chart

Prepared by: Viray, Regina***

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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 theaccomplishments of the main operations of the organization. The unithead has direct responsibility for the work of a unit.

Staff personnel provide advice, counsel or technical support that may beaccepted altered or rejected by the line officer.

GUIDELINES IN ORGANIZING1. Supply Market

- It is important that the local supplier capacity is properly researchedprior to organizing a business seminar to ensure that goods andservices are relevant to the needs.

2. Invitations

- The invitation should indicate the types of suppliers that will beattending the seminar.

3. Frequency

- Due to limited resources, and in order to be fair to all countries,generally only participate in one major supplier event per countryper year.

4. Facilities

- The organizing entity should ensure that the facilities are availablefor business seminars.

5. Agenda

- The agenda for the business seminar should be agreed with other participating organizations and the organizing entity.

6. Individual meeting with suppliers

- A program should be prepared in advance by the organizing entity.Each supplier meeting should be scheduled to last for no longer than 15 minutes.

7. Expenses

- Organizing entities in developed countries are expected to cover the travel expenses, hotel and meals for all participants.

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8. Supplier fees

- Any fees charged to suppliers for participating should be kept to aminimum and aim to only cover costs incurred.

9. Travel, Accommodation & other practical information- The organizing entity is responsible for making the necessary

accommodation arrangements for participants.

Prepared by: Arceo, Joanna Rose***

STAFFING

Is the process of determining providing the acceptable number

mix of nursing personnel to produce a desired level of care tomeet the patients demand.

Purpose of staffing

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 improper mixture of nursing personnel will adversely affect the quality and quantity of workperformed

such situation can lead to high rates of absenteeism and turn-over

resulting in low morale and dissatisfaction

Factors affecting staffing

Factors affecting staffing include:

1. the type, philosophy, and objectives of the hospital and the nursingservice;

2. the population served or the kind of patients served whether pay or charity;

3. the number of patients and severity of their illness-knowledge and ability

of nursing personnel are matched with the actual care needs of patients;4. availability and characteristics of the nursing staff, including education,level of preparation, mix of personnel, number and position;

5. administrative policies such as rotation, weekends and holiday off-duties;6. 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 safe nursing practice and/ or the hospitalsthemselves may formulate/develop their own standards;

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7. layout of the various nursing units and resources available within thedepartment such as adequate equipment, supplies, and materials;

8. budget including the amount allotted to salaries, fringe benefits, supplies,materials, and equipment;

9. professional activities and priorities in nonpatient activities like

involvement in professional organizations, formal educationaldevelopment, participation in research and staff development;10.teaching program or the extent of staff involvement in teaching activities;11.expected hours of work per annum of each employee. this is influenced by

the 40-hour week law; and12.patterns of work schedule-traditional 5 days per week, 8 hours per day; 4

days a week, ten hours per day and three days off; or 3 days of 12hours per day and 3 days off per week.

Selection of personnel

Recruitment and Retentionif a man proceeds confidently in the direction of his dreams and endeavors to live the life he has imagined, he will meet with successunexpected in common hours ------henry david Thoreau

The acquisition of qualified people in any agency is critical for theestablishment, maintenance and growth of the organizational. Therefore activerecruitment is important, and the attraction of qualified applicants is the firststep in selection of personnel.

Modes for active recruitment include:

employee recommendations and word of mouth advertisement in local newspaper, nursing organization

bulletins, and nursing journal recruitment literature, such as fliers and newsletter posters career days job fairs contract with schools graduating classes placement service open houses nursing conventions

Recruiters should know nursing qualifications and 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 selectionprocess.

Screening of Potential Staff

investment in well-qualified nurses can produce a high rate of return anderrors

whether they be failure to hire a promising nurse or hiring someone whofails to achieve the organizations expectations

can be expensive mistaken.

There are three underlying philosophy the screening process:

1. The manager should screen out applicants who do not fit the agencysimage.

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.

Application forms and resumes

Data in the personal history educational background, work experience,and other pertinent information----can be used to the following:

determine whether the applicant meets minimal hiring requirements, suchas minimal educational level or minimal job experience

furnish background data useful in planning the selection interview obtain names of references who may be contracted for additional

information about the applicants work experience and general character Collect information for personnel administration, that is, social security

number, number of dependents, and so forth.

Interview

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A preemployment interview to predict job success should be conductedwith the most qualified applicants

Purposes of the interview

to obtain information to give information to determine if the applicant meets the requirements for the position

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

The interview answers questions, explains policies and procedures, andhelps acquaint the applicant with the position.

Finally, the interviewer must predict whether the applicants overall

performance will be satisfactory.

Orientation

Induction is the first 2 o 3 days of orientation. It can be done by personneldepartment employees for all new employees.

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 is important, and the manager who does not take the time toassist a new employee is making a serious mistake.

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Because of the information overload, induction and further orientation shouldbe conducted over time. a checklist for orientation that indicates the content,time frame, and who is responsible to teach it can be helpful.

Prepared by: Chico, Jenelyn***

ASSIGNMENT SYSTEM FOR STAFFING :

Changes in assignment systems are a response to changing needs. shortage of nurses manage competition care to patient through primary nursing

System Used in Staffing

Case Method

Each patient is assigned to a nurse for total patient carewhile that nurse is on duty.Functional Nursing

Hierarchical structure predominant Efficient system that is least costly and requires few RNs

Team Nursing Group or Team action Led by a professional or Technical Nurse who:

PlanInterpretsCoordinatesSuperviseEvaluates

Team member is encourage to make suggestion andideas

Primary Nursing Patient should be the focus of professional nurses

instead of task The RN remains responsible for the care of the patient 24

hrs per day throughout the patient hospitalizationModular or District Nursing

Modification of Team and primary nursing Uses smaller team who are grouped geographicallyManaged Care

Focused from acute care to promotion of health anddisease management of chronic and terminal care

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 Assignment System

SYSTEM Advantages DisadvantagesCase Method Total patient care Different nurse, different shifts,

different days

FunctionalNursing

Efficiency Nurses do managerial workNurses aides do patient careTime needed to coordinatedelegated work.

Team nursing Team effortFrees patient carecoordinator to manage theunitNursing care conferenceshelp problem solve anddevelop staff Nursing care plan

Time needed to coordinatedelegated work

Modular nursing Useful where there are fewRNsRNs plan care

Paraprofessionals do technicalaspects of care

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Primary Nursing RNs give total patient carePrimary nurse has 24-hour responsibilityAssociate nurse works withpatient while the primary

nurse is off dutyAccountability in placeContinuity of care isfacilitatedReduces number of errorsfrom relay of ordersFewer patient complaintsShorter hospitalization

Confines nurses talents to a

limited number of patients

Associates nurse may change

care plan without discussing

with primary nurse

Managed Care Incorporates casemanagementCan be used with anynursing care deliver systemStandard critical pathsIncreases efficiencyReduces costs

Questionable continuity of care

CaseManagement Focuses on entire episodeof illnessEmphasizes achievementof outcomesCare is coordinated by acase manager Second-generation primarynursingCritical pathsVariation analysisIntershift reports

Health care team meetingInterdisciplinary

Effort to coordinate

Prepared by: Evangelista, Jenalyn***

Staffing Schedules for Productivity

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SCHEDULING

- is the process of deciding how to commit resources between avariety of possible tasks. Time can be specified or floating as part of asequence of events.

TYPES OF SCHEDULING:

Centralized Schedule - one person, usually the chief nurse or her designate,assigns the nursing personnel to the various units of the hospital. Thisincludes the shifts on duty and off-duty.

Decentralized Schedule - the shift and off duties are arranged by thesupervising nurse or head or senior nurse of the particular unit.

Self Schedule - it is a system that is coordinated by staff nurses. It is aprocess by which nurses and other staff collectively develop and implementwork schedules, taking policies and variables affecting into consideration.

Prepared by: Mendoza, Angelica***

Patient Care Classification System

The patient care classification system is a method of grouping patientsaccording to the amount and complexity of their nursing care requirements andthe nursing time and skill they require. This assessment can serve in determiningthe amount of nursing care required, generally within 24 hours, as well as thecategory of nursing personnel who should provide that care.

To develop workable patient classification system, the nurse manager mustdetermine the following:

1. The number of the categories into which the patients should be divided;2. The characteristics of the patients in each category;3. The type and number of care procedures that will be needed by typical

patient in each category; and4. The time needed to perform these procedures that will be requires by a

typical patient in each category.

The number of categories in the patient classification may range fromthree to four, which is the most popular, to five or six. These classes relate to theacuity of illness and care requirements, whether minimal, moderate, or intensivecare. Other factors affecting classification system would relate to the patientscapability to meet his physical needs to ambulate, bathe, feed himself, and other instructional needs including emotional support.

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Patient care classifications have been developed primarily for medical,surgical, pediatrics, and obstetrical patients in acute care facilities.

Classification Categories

The various units may develop their own ways of classifying patient careaccording to the acuity of their patients illnesses. Following is an example of apatient care classification in medical- surgical unit.

LEVEL I- Self Care or Minimal Patient can take a bath his own, feed himself, feed and perform his

activities of daily living. Falling under this category are patients about to bedischarged. Those in non-emergency, those newly admitted, do not exhibitunusual symptoms, and requires little treatment/ observation and / or instruction.Average amount of nursing care hours per patient per day is 1.5. Ratio of professional to non- professional nursing personnel is 55:45.

LEVEL II- Moderate Care or Intermediate CarePatients under this level need some assistance in bathing, feeding, or

ambulating for short periods of time. Extreme symptoms of their illness musthave subsided or have not yet appeared. Patients may have slight emotionalneeds, with fluids or blood transfusion; are semi-conscious and exhibiting somepsychosocial or social problems; periodic treatments, and/ or observation and/ or instruction. Average nursing care hours per patient per day is 3and the ratio of professional non-professional personnel is 60:40.

LEVEL III- Total, Complete or intensive Care

Patient under this category are completely dependent upon the nursingpersonnel. They are provided complete bath, are fed, may or may not beunconscious, with marked emotional needs, with vital signs and therapy, and withchest or abdominal tubes. They require close observation at least every 30minutes for impending hemorrhage, with hypo or hypertension and / or cardiacarrhythmia. The nursing care hour per patient per day is 6 with a professional tonon-professional ratio of 65:35.

LEVEL IV- Highly Specialized Critical CarePatients need maximum nursing care with ratio of 80 professionals to 20

non-professionals. Patients need continuous treatment and observation; withmany medications, IV piggy back; vital signs every 15-30 minutes; hourly output.There are significant changes in doctors orders and care hours per patient per day may range from 6-9 or more, and the ratio of professionals to non-professionals also range from 70:30 to 80:20.

Prepared by: Surban, Katrina***

Republic Act 5901 The Fourty Hour Week Law

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- Provides that employees working in the hospitals with 100 bedcapacity and up will work only 40 hours a week.

- Employees working in agencies with less than 100 bed capacityor in agencies located in communities with less than one million

populations will work 48 hours a week and therefore will get onlyone off- duty a week.

Civil Service Commission as per Memorandum Circular No.6, series of 1996- Granting of the three-day special privilege to government

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 week

40 hours

Working hours per week

48 hours1. Vacation leave 15 152. Sick leave 15 153. Legal holidays 10 104. Specials holidays 2 25. Special privileges 3 36. Off duties as per

R.A. 5901104 52

7. Continuingeducation program

3 3

Total non-working daysper year

152 100

Total working holidays per year

213 265

Total working hours per year

1,704 2,120

Total number of working and non-working days and hours of nursing personnelper year SCHEDULED METHOD PROS CONS

SELF-SCHEDULING - coordinating by staff nurses-saves manager scheduling time-helps developaccountability-increases perception of autonomy

-increases amount of time staff spends onscheduling

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-increased jobsatisfaction-improved team spirit-improved morale-decreased absenteeism

-reduced turnover -effective for recruitmentand retention

ROTATING WORKSHIFTS

-can rotate teams -rotate among shifts-increased stress-affect health-affect quality of workDisrupt development of works group-high turnover

PERMANENT SHIFTS -can participate in social

activities-job satisfaction-commitment to theorganization-few health problem-less tardiness-less absenteeism-less turnover

-most people want day

shift-new graduatespredominantly staff evening and nights-difficulty evaluatingevening and night shift-nurses may notappreciate the workloador problems of other shift

BLOCK, OR CYCLICALSCHEDULING

-same schedulerepeatedly

-nurses not so exhausted-sick time reduced-personnel knowschedule in social events-decreased time spendon scheduling-staff treated fairly-helps establish stablework groups-decreased floating-promotes continuity of

care

-rigidity

VARIABLES STAFFING -use census to determinenumber and mix of staff -little need to call inunscheduled staff

ALTERNATING OR ROTATING WORK SHIFTS

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- The frequency of alternating between days and evening, or daysand nights, or rotating through all three shifts may vary amonginstitutions. Some nurses may work all three shifts within 7days.

- Alternating and rotating work shift create stress for staff nurses,environmental cues, such as: sunrise and sunset, fluctuate in apredictable cycle.

- Instrument s that designate hours, minute, and secondscorrespond to the natural daily cycle and allow knowledge of ones location in that cycle.

- The ability of the body function to adjust varies considerablyamong individuals; it takes 2 to 3 days to 2 weeks for a person

to adjust to a different sleep-awake cycle.PERMANENT SHIFTS

- Permanent shifts relieve nurses from stress and health-relatedproblem associated with alternating and rotating shift.

- When nurses are able to choose the shift that best suits their personal life, they can participate in social activities, even whenthey require regular attendance.

- In studies conducted with MONTREAL NURSES, those working

permanent shifts had higher average on psychological scalessuch as: mental health, job satisfaction, social involvement, andcommitment to the organization.

BLOCK OR CYCLICAL SCHEDULING- Uses the same schedule repeatedly. With a 6-day forward

rotation, personnel are scheduled to work6 successive daysfollowed by at least 2 days off. The scheduled repeats it every 6weeks.

- Personnel can be scheduled with every other weekend off and 1day during the week so that there are more than 4 consecutivedays of are not exhausted by working too many consecutivedays, sick leave can be reduced.

TEN HOURS PER DAY, FOUR-DAY WORK PER WEEK- A cyclical scheduled allowed at least 14 hours off between shifts

and a 4-day weekend every 6 weeks for those who rotated.

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- The work week began on Sunday and the weekend wasSaturday and Sundays for all shifts.

Variables staffing PROS CONS8 hours Traditional

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 staffingrequirements,Lower cost per patientday,Increased knowledge of

patients,Get new admissionsettled,Not so rushed,Better continuity of care,Team development ispossible,Less daily to do staffing,Reduced travel time,Less personal expensesfor gas, meals,

babysitting

Overtime,Exhaustion increases atend of workweek,Tension increased at theend of workweek,

Increased in minor accident,Increased medicationerrors,Home and social lifesuffer the week worked.

Prepared by: Santos, Baby Richelle

***

Determination of Number of Nursing PersonnelIn computing for the number of nursing personnel in the various nursing

units of the hospitals, one should ensure that there is sufficient staff to cover allshifts, off-duties, holidays, leaves, absences, and time for staff developmentprogram.

Steps in Computing Number of Nursing Personnel

1. Categorize the patients according to the levels of care needed. Multiplythe total number of patients by the percentage of patients at each levelof care (whether minimal, intermediate, intensive or highly specialized).

2. Find the total number of nursing care hours needed the patients ateach category level.

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a. Find the number of patients at each level by the average number of nursing care hour needed per day.

b. Get the sum of the NCH/day needed at the various levels. .

3. 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.

4. Find the actual number of working hours rendered by each nursingpersonnel per year. Multiply the number of hours on duty per day bythe actual working days per year.

5. Find the total number of nursing personnel needed.a. Divide the total number of nursing care needed per year by the

actual number of working hours rendered by an employee per year.b. 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 those working 48 hours per week).c. Add the number of relievers to the number of nursing personnel

needed.

6. Categorize the nursing personnel into professionals and non-professionals. Multiply the number of nursing personnel according tothe ratio of professionals to non-professionals.

7. Distribute by shifts.

Reference Table

Table 1. Percentage of patients at various levels of care per type of hospital.

Percentage of Patients in Various Levels of CareType of Hospital MinimalCare

ModerateCare

IntensiveCare

HighlySpl.Care

Primary HospitalSecondary HospitalTertiary HospitalSpecial Tertiary

70653010

25304525

55

1545

--

1020

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Hospital

Table 2. Categories or levels of care of patients, nursing care hours neededper patient per day and ratio of professionals to non-professionals.

Level of Care NCH NeededPer Pt. Per Day

Ratio of Prof.to Non-Prof.

Level ISelf Care or Minimal Care

Level IIModerate or Intermediate Care

Level IIITotal or Intensive Care

Level IVHighly Specialized or Critical Care

1.50

3.0

4.5

6.07 or higher

5:45

60:40

65:35

70:3080:20

Table 3. Percentage of personnel needed in every shift.

Distribution by ShiftsShift Nursing Personnel

Morning ShiftAfternoon Shift

Night Shift

45 -5134- 3715- 18

Prepared by: De Leon, Joseph Rommel ***

report of bsn 4c2 ncm 105

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