chapter 16 Flashcards
The number of adverse events such as falls and pressure ulcers on your unit is increasing.
An ideal staffing plan to address this issue would include which of the following?
a. Increasing the total number of staff on the unit.
b. Increasing the staff and registered nurse (RN) hours per patient.
c. Increasing the total number of staff and implementing 12-hour shifts.
d. Increasing the number of RNs and number of RNs with experience on the unit.
D
A small rural hospital has been designated as a critical access hospital. It has 40 beds and an
average occupancy rate of 34 beds. To prepare the staffing, the chief nursing officer
computes the occupancy as being;
a. 90%.
b. 85%.
c. 75%.
d. 60%.
B
To prepare staffing schedules, a nurse manager needs to calculate paid nonproductive time.
When calculating paid nonproductive time, the nurse manager considers:
a. Work time, educational time, and holiday time.
b. Paid hours minus worked hours.
c. Vacation time, holiday time, and sick time.
d. Paid hours minus meeting time.
C
An important aspect of managing the costs on a unit is to plan accurately for staffing needs.
Nurse managers use staffing plans to:
a. Assign staff on the unit on a daily basis.
b. Ensure that days off are planned for the staff.
c. Outline the number of individuals by classification on a per-shift basis.
d. Predict the numbers and classifications of float staff needed to augment regular
staff.
C
A nurse manager must consider a number of external variables when preparing the
personnel budget and projecting the unit’s staffing needs. An external consideration is:
a. Organizational staffing policies.
b. Staffing models.
c. Changes in services that will be offered.
d. Department of Health licensing standards.
D
A nurse manager must also consider a number of internal variables that will affect staffing
patterns. Which of the following is an internal variable to be considered?
a. Organizational staffing policies.
b. Provincial/territorial licensing standards.
c. Canadian Nurses Association guidelines.
d. Consumer expectations.
A
A nurse manager uses many sources of data when planning the unit’s workload for the year.
Which of the following data must be considered in the planning?
a. Hours of operation of the unit.
b. Trends in the numbers of acutely ill patients on the unit.
c. Maximum work stretch for each employee.
d. Weekend requirements.
B
Scheduling is a function of implementing the staffing plan by assigning unit personnel to
work specific hours and specific days of the week. To retain nursing staff, the nurse
manager must schedule:
a. All weekends off.
b. All holidays off.
c. A variety of scheduling options.
d. Rotating shifts.
C
The difference between staffing and scheduling is that staffing:
a. Puts the right person in the right position.
b. Puts the right person in the right time and place.
c. Refers to the number of nursing hours per patient per day.
d. Accounts for interpretation of benefits and compensation.
A
A busy neurologic intensive care unit and a step-down unit are most likely to use which
patient classification system?
a. Factor evaluation.
b. Prototype evaluation.
c. Canadian National Database of Nursing Quality Indicators.
d. Agency for Healthcare Research and Quality (AHRQ) system.
A
Factor evaluation systems involve classification systems in which:
a. Financial data are used to determine staff-to-patient ratios.
b. Diagnosis-related groups are used to determine the numbers of acutely ill patients
on a unit.
c. Interventions and time required for interventions are combined to determine the
levels that are required.
d. Financial resources and nursing interventions are combined to determine patient
contact hours.
C
Staff members on your unit raise concern that the number of acutely ill patients on the unit
is rising and responsiveness in addressing these needs through appropriate staffing is
lacking. They point to increased incidences of adverse and sentinel events on the unit. To
address this concern, the best action for your hospital organization is to:
a. Implement a patient classification system immediately.
b. Participate in databases that compare the outcomes and staffing levels versus those
of institutions similar to yours.
c. Provide increased numbers of staff to the unit.
d. Ignore such concerns because the number of acutely ill patients is variable.
B
A particular classification system assigns revenue according to the functional capacity of
patients and the progression of patients during their stay in rehabilitation units. More
independent patient activities such as prompted voiding require higher staff utilization than
do dependent activities but do not result in increased staff resources. This is an example of:
a. Bureaucracy.
b. Concern related to the validity of classification systems.
c. Inadequate reliability of classification systems.
d. Inappropriate subjectivity in making judgements about staffing.
B
In the past year, you have noticed an increase in patient falls on your unit. In reading studies
related to staffing and patient outcomes, you realize that you will need to plan for:
a. Higher patient care hours.
b. Safer facilities.
c. Institution of a patient classification system.
d. An increased number of RN positions.
D
In evaluating mortality rates, the head nurse on the cardiac unit is surprised to find that they
are higher on the weekend than on weekdays. In exploring the reasons for this apparent
anomaly, the head nurse focuses on:
a. Availability of diagnostic personnel.
b. Availability of physicians.
c. Communication with on-call providers.
d. Numbers of acutely ill patients.
C
