Exam 8 Flashcards
Formula for nursing care hours per pt-day
NCH/PPD
Patient census (#of pts)
Nursing care hours per pt day
Acuity of pt doesn’t matter
Nursing & ancillary staff
Staffing can be incomplete
Doesn’t present reality of what’s occurring on a nursing unit
Pt classification systems (PCS)
Result of inadequate NCH/PPD AKA workload management Or pt acuity tool Group pts due to acuity Pts are classified once /day
As a pt becomes sicker the acuity level?
Rises
acuity level 1
2.2 hours of care
acuity level 2
2.6 hours of care
acuity level 3
3.2 hours of care
acuity level 4
3.6 hours of care
one FTE (full time equivalent)
40 hours a week for 52 weeks,
one FTE can be filled by one person or a combination of staff
FTE productive hours
hours worked and available for pt care, most orginazations allow 2-15 min breaks which are considered time worked
FTE non productive hours
benefits, orientation, sick & holiday, education time, meal breaks
direct care vs indirect care
direct care is actual hours spent provided hands on care to pt
indirect is spent on activities that are r/t the pt, such as documentation, follow up, consulting with other health care providers
FTE formula
avg. nursing care hours x days in staffing period x pt census
_________________________________
80 (hours worked per FTE)
the process of making the personnel work assignment for a specific period of time
scheduling
centralized scheduling
work days and time off are repeated in regular cycles, such as Q 4 weeks
scheduling made by staffing office
decentralized scheduling
the unit managers are given the authority & assumes responsibility of staffing their own unit, staff feels more in control
self scheduling
coordinated by staff nurse, policies and rules, 4 week process, staff negotiate before and after work, unit manager reviews to make sure of coverage & refinements are met
alternating of rotating shifts
alt. between days and nights, rotating through all shifts, creates stress (sleep wake cycle)
traditional 8 hour shift
work 5 days, 40 hour week
done to decrese risk of errors
10 hour 4 day workweek
14 hours off between shifts, 4 day weekend Q 6 weeks
12 hour shift
3 days on 4 days off
goal of staffing and scheduling
to provide an adequate mix of nursing staff to match care needs
what does joint commision require that organizations determine criteria for what
Rn staffing and provide adequate # of competent staff to meet that criteria
pt classification systems use what
pt needs to determine workload requirements and staffing needs
oldest method of organizing care, take care of one patient and all of their needs “private duty” nursing, nurse is responsible for planning, organizging, and performing ALL care of a pt or group of pts, care provided in home
Total pt care or case model
ICU, PACU, CCU
what are the advantages of the Total pt care or case model
autonomy & responsibility
holistic and unfragmented care
requires skilled nursing
close relationship between RN & pt
disadvantages of total pt care or case model
inexperienced RN, cost (RNs are expensive)
nurses are assigned to TASKS not to pts
functional model or task nursing
characteristics of functional model or task nursing
ancillary staff were needed, bridge gap of nurses, Rn became manager of care rather than direct provider evolved during Depression
advantages of functional model or task nursing
very efficient, accomplish a lot in small amt of time, care was provided by minimal # of RN, staff only did what capable to do
disadvantages of functional model or task nursing
RN time to supervise UAP
care of PT became fragemented
narrow scope of practice for RN
focus was on task not overall result
most common model used, evolved in 50’s, goal was to decrease fragmented care, ancillary personnel provided care under direction of an RN, RN is team leader, requires good communication and coordination
Team model
advantages of team model
each members capabilities are maximized so satisfaction should be high, requires excellent communication, pts have one nurse (team leader), and access to other providers
