staffing pt 2

describe organizational staffing policies

organizations need fair and consistent policies that address

1. sick leave

2. vacations

3. holidays

4. call offs for low census

5. on call pay

6. tardiness and absenteeism

7. FML

where do staffing numbers come from?

national benchmarks

historic performance

best practice internally

what are the three main models of nurse staffing?

budget based: in which nursing staff is allocated according to nursing hours per patient day or some other metric form

1. inpatient units: NHPPD, nursing care hours/patient days

2. surgery: minutes per case

nurse patient ratio: in which the number of nurses per number of patients determines staffing levels

patient acuity: patient characteristics are used to determine a shifts staffing needs, acuity rating scale tool

how are nursing hours calculated?

NCH/PPD: nursing hours worked in 24 hours/patient census

what are common shift scheduling options in health care organizations?

8, 10, 12 hour shifts

twelve hour shifts have become commonplace in acute care hospitals even though there continues to be debate about whether extending the length of shifts results in increased judgement errors related to fatigue and increased sick time

describe the categories of state staffing laws

the first to require hospitals to have a nurse driven staffing committee which create staffing plans that reflect the needs of the patient population and match the skills and experience of the staff

the second approach is for legislators to mandate specific nurse to patient ratios is legislation or regulation

a third approach is requiring facilities to disclose staffing levels to the public and/or regulatory body

what is pro California?

2010 Aiken sloane, cimiotti, flynn, sago, spetz, smith

implications of the California nurse staffing mandate for other states

what is mandatory overtime?

in mandatory overtime, employees are forced to work additional shifts, often under threat of patient abandonment

while mandatory overtime is neither efficient nor effective in the long term, it has an even more devastating short term impact in terms of staff perceptions of lack of control and its subsequent impact on mood, motivation, and productivity

what are the effects of decreased hours of nursing care?

staffing levels should be considered an important but not only factor in safe patient care

review of current literature consistently and overwhelmingly demonstrates that as nursing hours decrease adverse patient outcomes increase (medication errors/falls) and decrease patient satisfaction

what is the relationship between staffing and quality of care?

suggested that as numbers of staff increase the numbers of adverse events, mortality, and readmission decrease

pay for performance