Scenario – Staffing is an important part of nursing management as healthcare is very labor intensive. Since nursing is a major expense in any institution it is oftentimes the area where administrators will try to save money, sometimes forsaking quality and increasing the chances that there will be disgruntled nurses after a short time. The following scenarios are for two units in the same hospital so acuity levels will be the same. Acuity levels are as follows: #1=4.0; #2=3.2; #3=2.3; #4=1.4. The first unit is the ICU. The second is a Med-Surg floor.
ICU Unit
RN scheduled: 4
Unit Secretary scheduled: 1
6 patients = #1 acuity
2 pts = #2 acuity
- 0 pts = #3 acuity
- 0 pts = #4 acuity
- Med-Surg Unit
- RN Scheduled: 2
CNA Scheduled: 1
Unit secretary scheduled: 1
1 pts. = #1 acuity
2 pts. = #2 acuity
3 pts. = #3 acuity
- 2 pts. = #4 acuity
- Instructions:
- Please calculate the proper staffing for each unit along with the hours for a unit secretary.
- Be sure to show each step in your calculation with an explanation for each of the steps.
There is an explanation of this in your book on page 245-247.
Based on the scheduled RN/CNA/unit secretary (if any) – is the unit staffed appropriately? Do you have too many staff scheduled? If yes, who would you flex/cancel? Do you have not enough staff? If yes how would you fix this (consider cost as well).
How to solve
Staffing Answer
Introduction:
In this assignment, we are presented with two scenarios from different units within a hospital: the Intensive Care Unit (ICU) and a Medical-Surgical (Med-Surg) floor. Our task is to calculate the proper staffing for each unit and determine if the units are staffed appropriately based on the scheduled RN, CNA, and unit secretary (if any). We will also consider the potential need for adjustments in staffing, taking into account both quality of care and cost considerations.
Answer:
To calculate the proper staffing for each unit, we need to consider the acuity levels of the patients and the number of staff scheduled for each role.
ICU Unit:
– RN scheduled: 4
– Unit Secretary scheduled: 1
– Patient Acuity:
– 6 patients with #1 acuity
– 2 patients with #2 acuity
– 0 patients with #3 acuity
– 0 patients with #4 acuity
To determine the proper staffing for the ICU unit, we need to consider the recommended nurse-to-patient ratio for each acuity level. According to the given acuity levels, the ratios are as follows:
– #1 acuity: 1 nurse for every 4 patients
– #2 acuity: 1 nurse for every 3 patients
– #3 acuity: 1 nurse for every 2.3 patients
– #4 acuity: 1 nurse for every 1.4 patients
Calculating the required number of nurses for each acuity level:
– #1 acuity: 6 patients / 4 = 1.5 nurses (rounded up to 2 nurses)
– #2 acuity: 2 patients / 3 = 0.67 nurses (rounded up to 1 nurse)
– #3 acuity: 0 patients
– #4 acuity: 0 patients
Considering the required number of nurses for each acuity level, we can determine the total number of nurses needed in the ICU:
– Total nurses needed: 2 nurses + 1 nurse = 3 nurses
Comparing the required number of nurses (3) with the number of RNs scheduled (4), it appears that the ICU unit is appropriately staffed with a slightly higher number of RNs than required.
Med-Surg Unit:
– RN Scheduled: 2
– CNA Scheduled: 1
– Unit Secretary scheduled: 1
– Patient Acuity:
– 1 patient with #1 acuity
– 2 patients with #2 acuity
– 3 patients with #3 acuity
– 2 patients with #4 acuity
Using the same approach as before, we calculate the required number of nurses for each acuity level:
– #1 acuity: 1 patient / 4 = 0.25 nurses (rounded up to 1 nurse)
– #2 acuity: 2 patients / 3 = 0.67 nurses (rounded up to 1 nurse)
– #3 acuity: 3 patients / 2.3 = 1.3 nurses (rounded up to 2 nurses)
– #4 acuity: 2 patients / 1.4 = 1.43 nurses (rounded up to 2 nurses)
Calculating the total number of nurses needed in the Med-Surg unit:
– Total nurses needed: 1 nurse + 1 nurse + 2 nurses + 2 nurses = 6 nurses
Comparing the required number of nurses (6) with the number of RNs scheduled (2), we can see that the Med-Surg unit is understaffed with an insufficient number of RNs scheduled.
Considering the unit secretary scheduled for each unit:
– ICU: 1 unit secretary
– Med-Surg: 1 unit secretary
It appears that both units have an appropriate number of unit secretaries scheduled.
In summary, based on the scheduled RNs and CNAs for each unit, we can conclude the following:
– The ICU unit is appropriately staffed with a slightly higher number of RNs than required.
– The Med-Surg unit is understaffed with an insufficient number of RNs scheduled.
To address the staffing issue in the Med-Surg unit, we can consider two potential solutions:
1. Hire more RNs to meet the recommended nurse-to-patient ratios for each acuity level. This would improve the quality of care provided but would also increase the cost.
2. Redistribute the existing RNs from the ICU unit, which has a slightly higher number of RNs scheduled than required, to the Med-Surg unit. This would optimize staffing levels without incurring additional costs.
Ultimately, the decision on how to fix the staffing issue should carefully consider both the quality of care and cost implications.
