Man: Test 2 staffing

Question 1

Staffing decisions made by a central office, they don’t know what is going on

Answer 1

Centralized:

Question 2

Advantage-fairer to all employees, frees unit manager to perform other tasks, most efficient cost effective use of resources

Answer 2

Centralized:

Question 3

Disadvantage- not much flexibility for staff, manager may be less responsive to person al budget control, don’t know what is going on in unit=frustrating to staff

Answer 3

Centralized:

Question 4

Staffing decisions made at the unit level, manager or charge nurse

Answer 4

Decentralized:

Question 5

Advantages- unit manager understands need of the unit and knows staffer personally, staff feels more in control of their work environment, increased autonomy and flexibility, decreasing nurse attrition= quitting, better relationship with manager better understanding= ex: daughter sick get time off

Answer 5

Decentralized:

Question 6

Disadvantages-unequal and inconsistent treatment, time consuming fore manger, hard to ensure high quality staffing decisions through organization

Answer 6

Decentralized:

Question 7

Ex: CCU to work ICU/ can float back and forth when one is short

Answer 7

Coverage with Shortages

Long term: Cross-training staff-

Question 8

-Long term: Cross-training staff
-Short term:
A. Closed unit staffing
B. Mandatory overtime

Answer 8

Coverage with Shortages

Question 9

• staff is going to cover all absents, keeps them from being pulled from unit, staffing own unit

Answer 9

Short term:

Closed unit staffing

Question 10

• employee forced to work extra shift, can get threat that you’re abandoning your patient and can get fired, last resort

Answer 10

short term

Mandatory overtime

Question 11

• Higher nurse satisfaction if policies and procedures are clearly communicated.
• Written policies provides consistency and fairness amongst employees.
• Polices communicate in advance consequences of various personnel matters such as tardiness or absenteeism. Ex: Shift rotation, Low census, Holiday, Overtime, Weekend rotation, Request off days
• Policies should be written in a way that allows some flexibility-not all black and white.

Answer 11

Staffing and Scheduling Policies

Question 12

• oldest model, nurses assume total responsibility of patients during the shift, provides with a lot of autonomy and responsibility, expensive and confusing to patient because nurses can have different ways for caring for you
• Assignments are simple and direct and does not require the planning that other methods of patient care delivery require
• Lines of responsibility and accountability are clear
• Holistic and un-fragment care

Answer 12

Total Patient Care

Question 13

• nurse inadequately prepared or inexperienced and can’t provide care

Answer 13

Total Patient Care

disadvantage

Question 14

• opportunity for less qualified personnel for cheaper rate, care through others , Tasks are completed quickly, Little confusion regarding responsibilities, Care provided with a minimal number of RNs Ex: charge, QMA , CNA/ assisted personnel are provided job duties not specific patients
  Ex: LPN- dressing changes, Cna- bathroom and bath, RN – became more of manager

Answer 14

Functional Nursing

Question 15

Advantage- economical and efficiency, best in OR and long term care facilities

Answer 15

Functional Nursing

Question 16

Disadvantage- fragmented care, low job satisfaction

Answer 16

Functional Nursing

Question 17

way to reduce fragmented care, 5 staff caring in a group, *must have good communication

• Ancillary personnel collaborate in providing care to a group of patients under the direction of a professional nurse
• Nurse responsible for knowing condition and needs of all patients assigned to the them and for planning individual care
• Comprehensive care can be provided for patients despite a relatively high proportion of ancillary staff
• Democratic leadership
• Group leaders given as much autonomy as possible, and shares responsibility and accountability
• Allows members to contribute own special expertise or skills

Answer 17

Team Nursing-

Question 18

Advantage- gives team autonomy, increase job satisfaction

Answer 18

Team Nursing-

Question 19

Disadvantage- blurred lines of responsibility, errors, fragmented care

• Improper implementation rather than with the philosophy itself
• Insufficient time allowed for care planning and communication

Answer 19

Team Nursing-

Question 20

rn at bedside, good used in hospital, home health, and hospice
-considered to have 24 hour accountability for patient= bc your completely responsible for plan of care, get same patient back and see what has been going on, any adjustments going on has been done

Answer 20

Primary Nursing-

Question 21

• care for patient during absents, make sure they do care on plan, and recommend changes

Answer 21

Primary Nursing-

Associate nurse

Question 22

Advantage- holistic, high quality care, high job satisfaction to Rn

Answer 22

Primary Nursing-

Question 23

Disadvantage- new grads bc so much learning, this model is hard at beginning to keep in order , harder now because 12 hour shifts because off more days a week

Answer 23

Primary Nursing-

Question 24

RN- responsible for team, manage communication to make sure all on same page, dev care plan and receives feedback= doctors, therapy’s, dietary, wound care/ relationship based model

Answer 24

Primary Nursing-

Question 25

also known as workload management or patient acuity tools.
-Groups patients according to specific characteristics that measure acuity of illness to determine both number and mix of staff needed to care for patients.
equation

Answer 25

PCS
Patient Classification Systems
add up all pt care hours
add up all total hours for staff (number of staff X hrs per shift)
subtract pt care hours minus staff hours= determine if under or over hours

Question 26

uses broad indicators such as Bathing, Diet, IV fluids, Medications, Positioning

Answer 26

PCS Tools

Critical indicator:

Question 27

: Requires nurse to note frequency of occurrence such as treatments and procedures for each patient. Did a patient require nursing time for each event such as teaching, bathroom or hygiene?
-Must look at staff competency, experience, regular vs. visiting staff and skill mix.
-Manager must also look at internal/external factors affecting unit needs such as:
Increase in nursing or medical students
Lower skill level of new graduates
Cultural and/or language difficulties

Answer 27

pcs tools

Summative Task