8.3 Safe Staffing and Scheduling

Question 1

Nurse Staffing

Answer 1

• Essential to optimize patient outcomes and deliver high quality care
• Measured based on analyzing overall revenue generation, cost avoidance, readmission rates, and length of stay.

Question 2

Core Components for Optimal Nurse Staffing

Answer 2

1 - All settings should have well developed staffing guidelines with measurable nurse-sensitive outcomes specific to that setting and consumer population. Evidence is used to guide daily staffing

2 - RNs are full partners working with other healthcare professionals in collaborative, interdisciplinary partnerships

3 - RNs must have substantive and active role in staffing decisions to ensure the necessary time with patients to meet care needs and overall nursing responsibilities

4 - Staffing needs are determined based on an analysis of healthcare consumer status (stability, intensity acuity) and the environment in which care is provided.

5 - Nurse staffing should be based on allocating the appropriate number of competent practitioners to a care situation; pursuing quality of care indices; meeting consumer-centered and organizational outcomes; meeting federal and state laws and regulations; and attending to safe, quality work environment

6 - Cost-effectiveness is important in considering delivery of safe, quality care

7 - Reimbursement structure should not influence nurse staffing patterns or level of care provided

Question 3

Float Nursing, Mandatory Overtime, and Supplemental Staff

Answer 3

• Utilized to ensure enough qualified nurses are available to meet patient demands

Question 4

Float Nursing

Answer 4

• RN fills in when unit is short

Pros
- Flexible Schedule
- Increased salary/pay
- Work in various settings so knowledge and experience is increased
- Stay out of “unit politics”
- Covers shortage in staffing

Cons
- Trained in many units and does not have advance knowledge in any unit
- Maintenance of multiple certifications (BLS, ACLS, PALS, NRP)
- No control over unit assignment
- Limited knowledge of protocols and policies at various units
- Lack of specialization in a particular area including unit routines

Question 5

Mandatory Overtime

Answer 5

• RN forced to work hours beyond agreed upon hours

Pros
- Assists with ongoing shortage and high turnover rate
- Increased income

Cons
- Increase chance of error
- Decreases morale of workplace
- Increased risk of burnout, physical health, and wellbeing

Question 6

Supplemental Staff

Answer 6

• Agency nurses who help when staffing is low

Pros
- Higher pay per hour
- Travel to new places
- Less involved in organization politics
- Schedule flexibility
- Assists with ongoing shortage and high turnover rates

Cons
- Hours are not guaranteed
- No PTO or benefits
- Being away from family and friends for extended periods of time