Staffing Flashcards
Staffing
- Activities required to ensure an adequate # & mix of health care team members to meet pt needs & provide safe, quality care.
- Considerations are pt needs, staff satisfaction, & organizational needs.
- Usually a primary responsibility of the nurse manager
- Must address pt acuity levels, provide nurses time exercise professional judgment, & acknowledge that pt needs can change from moment to moment.
Primary considerations for staffing a nursing unit?
- # pts
- Intensity of care required
- Staff experience & preparation
- Geography of the environment
- Available technology
Patient Classifications Systems
Categorize pts according to specific criteria & care needs & thus help quantify the amt & level of care needed. (acuity level)
ANA recommendations for factors to consider w/ patient classification systems?
- Age & functional ability
- Communication skills
- Cultural & linguistic diversities
- Severity & urgency of admitting condition
- Scheduled procedures
- Ability to meet health care requisites
- Availability of social supports
- Other specific needs identified by pt & RN
3 basic organizational needs that are significantly affected by staffing?
- Financial resources
- Licensing regulations & accreditation
- Customer satisfaction
Total Patient Care
- Nurses responsible for planning, organizing, & performing ALL pt care during assigned shift.
Total patient care advantages?
- Autonomy
- Lines of responsibility & accountability clear
- Communication at shift change is simple & direct
Total patient care disadvantages?
- # RNs required is very costly
- Some tasks could be accomplished by a caregiver w/ less training & at a lower cost
- Nursing shortages will affect RN availability
What areas is total patient care commonly used?
ICU, PACU
Functional Nursing
Staff members are assigned to complete certain tasks for a group of pts rather than care for specific pts.
- RN nurse manager assigns responsibility for completion of tasks to a group of health care workers
- RN is responsible for planning care & supervising workers
- RN retains accountability for pt care provided
Functional nursing advantages?
- Economic & efficient
- Minimum # RNs required for pt care
- Tasks completed quickly, little confusion about responsibilities
Functional nursing disadvantages?
- May be fragmented; possibility of overlooking priority pt needs
- Pt may feel confused bc of many different care providers
- Caregivers may feel unchallenged when performing repetitive functions
What areas is functional nursing commonly used?
OR
Team Nursing
RN functions as a team leader & coordinates care for a sm group of pts.
- RN team leader is responsible for:
planning care
assigning duties
directing, supervising & assisting team members
giving direct care
- RN retains accountability for all pt care
- RN team leader responsible for encouraging a cooperative environment & maintaining clear communication
Team nursing advantages?
- High-quality, comprehensive care can be provided w/ a relatively high proportion of ancillary staff
- Each member participates in decision making, problem solving
- Each member contributes their own special expertise or skills
Team nursing disadvantages?
- Continuity of care may suffer w/ daily team assignments
- Team leader may not have the leadership skills required to effectively direct the team
- Insufficient time for care planning & communication leads to unclear goals & fragmented care
What areas is team nursing commonly used?
Inpt & outpt health care settings
Modular Nursing
- Modification of team nursing
- Pt unit divided into modules: same team of caregivers assigned consistently to same geographic location
- Each location or module has RN as team leader
- Goal: to increase the involvement of the RN in planning & coordinating care
- Designated modules should contain all the supplies needed by the staff to maximize efficiency
Primary Nursing
- RN “primary” nurse assumes 24hr responsibility for planning, directing, & evaluating the patient’s care from admission through discharge
- Provides total pt care while on duty
- Off duty - care is provided by an associate nurse who follows the care plan established by primary nurse
Primary nursing advantages?
- Direct pt care provided by a sm # of nurses allows for high-quality, holistic pt care
- Pt able to establish a rapport w/ the primary nurse & pt satisfaction is enhanced
- Job satisfaction high bc nurses are able to practice w/ high degree of autonomy & feel challenged & rewarded
Primary nursing disadvantages?
- Implementation may be difficult bc primary nurse is required to practice w/ a high-degree of responsibility & autonomy
- Inadequately prepared primary nurse may not be able to make the necessary clinical decisions or to communicate effectively w/ the health care team
- RN may not be will to accept 24 hr responsibility as required
- # RNs required for this model may not be cost-effective, & may be difficult to recruit & train
What areas is primary nursing commonly used?
Home health, hospice, LTC
Partnership Model (Co-Primary Nursing)
- RN is partnered w/ an LPN or NAC; pair work together consistently
- Modification of primary nursing designed to ensure more efficient use of RN
- RN is responsible for planning care, assigning duties, coordinating care, & supervising the partner
- RN is accountable for patient care for all assigned patients
Partnership model advantages?
- More cost-effective than primary nursing model
- RN can encourage training & growth of partner
