patient classification system,staffing

patient classification system,staffing for nurses
very important

1. Patient classification system Prepared by: 1- Ahmed Mohammed Zinhom 2- Amira El Sayed Under supervision: Prof: Nehad Fekry

2. 1. Define: staffing staffing pattern staffing plan staff mixes 2-Enumerate the goal of staffing. 3-List objectives of staffing.

3. 3-List types of staffing. 4-Identify methods for use of supplementary staff. 5-Identifiy factors affecting staffing pattern determination. 6-Defferentiate between the two types of staffing component. 7-Compare between tow types of patient classification system. 8-Estimating staff requirement for the different departments.

4. Out Lines: Introduction Definition of pcs Purpose of pcs. Importance of pcs. Types &styles of pcs. Prototype evaluation system. Factor evaluation system. Categories of pcs. Formula for nursing workload standard

5. -Definitions : staffing staffing pattern staffing plan staff mixes - The goal of staffing. - Objectives of staffing. - Types of staffing pattern. - Factors affecting staffing pattern determination.

6. Definition of staffing - Staffing refers to the number and mixture of personnel assigned to work in nursing units at a given time. - Is defined as human resources planning to fill positions on organization with qualified personnel . - Is process of determining and providing the acceptable number and mix of nursing personnel to met and produce desired level of care to meet the patient's demand for care .

7. - Filling position in the organization structure through identifying work force requirements , inventorying the people available , recruitment , selection , placement , promotion , appraisal , compensation , and training of needed people. Staffing pattern: Is a written plan that specifies the number and classification type of staff personnel who are needed to implement a care delivery model for each unit .

8. Staffing plan: Indicates how many persons of what job classification should be on duty per each unit per shift . Staff mixes: Is the skill level of individual delivering the required care ,In nursing it include : technical nurses and practical nurses.

9. The goal of staffing: - To provide adequate numbers of the right mixture of nursing personnel to give proper care to patients housed in the unit at a particular time .

10. Objectives of staffing: - Establish a balance between the nursing staff available with the manpower required ,according to the patients and their care needs - Provide sufficient staff to permit a1:1 nurse-patient ratio for each shift in every critical care unit.

11. Objectives of staffing cont; - Provide sufficient nursing staff general medical-surgical ,obstetrics ,pediatrics, and psychiatric units to permit a 1:5 nurse-patient ratio on day and afternoon shifts and 1:10 nurse-patient ratio on night shifts. - Summarize the data on actual versus required staff. - Improve moral, job satisfaction and quality care with decrease in turnover and vacancies .

12. Objectives of staffing cont; - Evaluate staffing practices periodically. - Recruit qualified personnel. - Provide new employees with orientation period. - Develop personnel policies that attract and provide effective staff member.

13. STAFFING PROCESS

14. Staffing is logical operation that consist of several interdependent actions, such as: 1)Identifying the type and amount of services needed by organization client . 2) Determining the personnel categories that have the knowledge and skill to perform needed services measures . 3) Predicting the number of personnel in each job category that will be needed to meet anticipated services demands .

15. 4) Obtaining budgeted points for the numbers in each job category needed to service for the expected types and number of clients. 5) Recruiting personal to fill available positions. 6) Selecting and appointing personnel from suitable applicant. 7) Combing personnel into desired configuration by unit and shift . 8) Orienting personnel to fulfill assigned responsibilities. 9) Assigning responsibilities for client services to available personnel.

16. Staff classification 1-Professional nurse : Baccalaureate degree . 2-Technical nurse: Secondary Technical Nursing School . ( Diploma degree ). 3-Auxiliary : messenger and transport personnel .

17. Components of Staffing 1- Staffing pattern: it is the number and mix of personnel that should be on duty per each unit per shift , per day . 2- Staffing plan: It determines the number of nursing personnel that must be hired to deliver nursing care on the nursing units .

18. 5-Types of staffing pattern: There are three essential methods of nurse staffing pattern: The traditional fixed staffing pattern. The controlled variable staffing pattern. The semi-flexible staffing pattern. 25/11/2010 16

19. The traditional fixed staffing pattern: In this method the staffing pattern is built around a fixed projected maximum workload requirement. Limitation of this method : it ignores the fluctuation in the work load(patients condition and number) or staff member condition(shortage ,absenteeism) 25/11/2010 17

20. II. The controlled variable staffing pattern: In this method, the units are staffed below the maximum workload conditions and staff is then supplemented as needed. Although this is very effective method for staffing , it creates dissatisfaction among staff. Method for use of supplementary staff : Borrowing method Floating method On – call staff 25/11/2010 18

21. Methods used in supplementary staff : A) Borrowing method This common method of borrowing staff from unit to unit .to help those who have too little staff . : The problem with this method is that 1- the staff often resent being transferred from unit to unit 2- the head nurse never admits that she has more nurses .

22. B) Floating method This is a better method for managing staffing needs . Nurses who are permanent workers but don't belong to any special units are used to fill any shortage in staff Advantage :- 1- help to manage the day to day variations in work volume . 2- some nurses like this method to gives her chance to work with different types of patient . C) on-call staff Usually on-call staff is filled with fixed staff that receive extra pay for being on call whether they are called or not . This method is useful in OR , ICU

23. III. The semi-flexible staffing pattern: In this method , about 10% to 15% of staff are fixed and the rest flexible (supplementary) and the volume is adjusted to match workload needs. 25/11/2010 19

24. 6-Factors affecting staffing pattern: Nursing organization factors. Patient factors. Staff factors. Health organization factors. 25/11/2010 20

25. Factors affecting staffing pattern Nursing organization factors 1.Patient care objectives 2.Determined level of patient care 3.Nursing division 4.Assignment system 5.Services to staff  

26. Patient factors from the organization Variety of patient conditions Acuity Length of stay Patient number Age groups ( pediatric , adults ) General health status and health goals

27. Staff factors 1- Job description 2- Educational level of staff 3- Experience level of staff 4- work ethics of staff members 5- Expectation of staff 6- staff number available

28. Health organization factors: 1- financial resources available 2- Personal polices 3- Support services within the organization 4- Numbers of beds per units 5- Budget available

29. Methods of determining the staffing pattern 1- The traditional system 1 - The number of beds per unit ( one nurse per 4-6 beds ), or 2 - The average census of patients per unit ( one nurse per 4 patients ).

30. The distribution of nurses is based on the nurse manager' opinion of the proportion of care that is needed on each shift and the adequate staff number to provide that care. Example: Days: 45% of the staff Evenings 35% of the staff Nights 20% of the staff The traditional system ignored that the group of patients might need more care than another group of the same number.

31. 2- The advanced system A- PATIENT CLASSIFICATION. B- TASK QUANTIFICATION .

32. Focuses on patient needs . Patients are grouped according to the acuity of their needs and the degree of their dependency on nurses. The patients grouped according to their nursing needs into 3 or more groups: Group 1: Self care Group 2: Partial or intermediate care Group 3: Intensive or total care

33. For example:-Determining nursing care hour by patient classification system in medical-surgical unit by No of pts Acuity level of care Associated hours of care Total No of hr needed 3 I 2 6 10 II 6 60 11 III 7 77 2 IV 9 18 36 161

34. Task quantification system Focuses on nursing tasks . To be performed. Common nursing tasks are either direct nursing care ( in the presence of the patient as in giving medication, measuring vital signs…..) or indirect nursing care ( away from the patients as in preparing medication , documentation in patients' files, giving instructions or educative sessions……)

35. 7-Staffing component: Staffing plan: Indicates scheme mathematically derived to indicate how many people of what classification must be hired in order to deliver staffing pattern. Staffing pattern determine positions which required to the unit or the hospital, but staffing plan determine the number of workers to fill those position. 25/11/2010 21

36. Methods of staffing plan: 1- Using calendar days: Divided the number of days in the year by the number of days actually worked per nurse per year to drive the number of staff required to fill one position for the year. Example : In some Hospitals in the ICU: The nurse worked 17 days per month So actual working days/year=17×12=204 days The number of nurses needed to fill one position of professional nurse = 364/204=1.8 worker. The number of nurses to fill 6 positions of LPN/year = 6*1.8=11 nurses.

37. 2-using the care hours:- Calculate P.T hours/unit/shift. Calculate the total number of nursing hours required/year. Calculate the number of staff required to deliver those hours. Calculate the number of positions required to deliver that staff.

38. Example : In the chemotherapy unit The patient needs 2 hours of care. The patient come to take this therapy daily=20. So the number of patient care hours = 2×20=40h/day. The number of hours in one shift= 8h. Then the nurse required to give these hours= 40/8= 5 P.N The number of workers to fill one position of nurse=1.65 So the number of nurses required to fill 5 positions of P.N = 5*1.65=8nurses

39. Factors influencing staffing plan: Job description. Personnel policies. Variability in patient care requirement. Budged resources. Equipment, supplies and technology. Staff category. 25/11/2010 22

40. Criteria for Effective Staffing Procedure An effective allocation procedure meets the following criteria: Coverage : the number of nurses assigned to be on duty should be in relation to the minimum number of nurses required Quality : the total number of patient care should be planned in such a way that trained nurses are available for patient care of 24 hours a day. It should also cover off days on rotation.

41. Criteria for Effective Staffing Procedure Stability : allocation procedure must be consistent with leave and rotation policy. Each nurse must know her off, privileged leave etc. Flexibility : the allocation policy must provide for flexibility e.g., if a request for days off or leave comes as emergency, that should be taken care of. Objectives : there should be fairness in allocation and scheduling shift duties

42. Written staffing policies should be readily available in at least the following areas :- 1- Vacations 2- Holidays 3- Sick leave 4- Weekend off 5- Over time 6- Part – time 7-Absenteeism 8-Emergency day off

43. II. Staffing pattern: Staffing pattern prediction: To predict the personnel allocation and scheduling system the manager has to the amount and type of nursing care needed in each nursing unit(nursing workload ). Work load component : Indirect care : which is consist in each unit Direct care : activities which is varies according to the number and type of patient (patient classification).

44. Patient classification system

45. Patients are classified according to the following criteria: 1-The activity of living 2-feeding 3-Grooming 4-Toileting 5-Comfort measures 6-Mobility

46. Criteria for Evaluating the Usefulness of Patient Classification Systems: 1- HOW Well Does the Patient Classification System Account for Variations in Patient Needs for Hospital Services? Identifying Patient Needs. Easy and quack adaptation with changed patient needs. resources . flexible.

47. Criteria for Evaluating the Usefulness of Patient Classification Systems: 2- How strong Is the Patient Classification System? refers to the ability of the system to maintain its properties despite changes in the data used to create or operate the system , persons using system.

48. Criteria for Evaluating the Usefulness of Patient Classification Systems: 3- How Reliable Are Patient Assignments to Category? Reliability should be assessed at several levels : primary data which as (sex, age, vital signs and lab test results , diagnosis,…) category assignment ( require subjective Judgment)

49. Criteria for Evaluating the Usefulness of Patient Classification Systems: 4- How Does the Patient Classification System Affect Economic Incentives? admission status (emergency vs. non emergency), Because emergency admissions have significantly higher costs and lengths of stay.

50. Criteria for Evaluating the Usefulness of Patient Classification Systems: 5- To What Extent Is the Patient Classification System Meaningful to Care providers? care providers must understand the system knowing PCS importance resources.

51. Criteria for Evaluating the Usefulness of Patient Classification Systems: 6- How Feasible and valuable Is the System To Use? classification systems that use more detailed data, revision, easy to use, understand. should be capable by computer to minimize cost , save time and enhance feasibility

52. Measurement of pcs : NCH / PPD = NURSING HOURS WORKED IN 24 HOURS PATIENT CENSUS

53. Using the care hours for developing staffing pattern Hospitals used the patient care hours for developing staffing pattern, can calculate the staffing plan using the care hours methods. For example:----------------------------------------------------------X Estimating a core staff per shift Bed number in surgical unit= 25 bed The average daily census for 6 month = 19 patients The average daily care hour to be provided= 5 hour per pt /24 hour . Total hours of care will be needed= 19x5= 95 hours. If the work day is 8 hours , then 95 divided on 8 = 11.9 or 12 FTE staff needed to unit for 24 hour.

54. Total of 12 EFT x 7 days / week = 84 shift / work--------------------------------x If the employee work 5 hours shift / week, then 84 5 = 16.8 the number of EFT needed. The needed on each shift and the adequate staff number to provide that care. Example: days: 45% of staff 45x16.8/100 =7.56=8 Evenings 35% of the staff 35x16.8/100 =5.88=6 Nights 20% of the staff 20x16.8/100 =3.34=3

55. Total Night Evening Day Category 9 5 3 2 1 - 3 2 1 4 2 2 RNs LPN Other 17 3 6 8 Total

56. Question????

57. THANK YOU