Staffing- Nursing Management

Manangement of Nursing Services and Administration

1. 1
Mr. Visanth V S
Asso. Professor
Dept of Psychiatric Nursing

2. 2
Staffing
Staffingisthesystematicapproachto
theproblemofselecting,training,
motivatingandretainingprofessionaland
nonprofessionalpersonnelinany
organization.
Itinvolvesmanpowerplanningto
havetherightpersonintherightplaceand
avoid“Squarepeginroundhole.”

3. 3
Functions of Staffing
Identifying the type and amount of service needed by agency client.
Determining the personnel categories that have the knowledge and
skill to perform needed service measures.
Predicting the number of personnel in each job category that will be
needed to meet anticipated service demands.
Obtaining, budgeted positions for the number in each job category
needed to service for the expected types and number of clients.
Recruiting personnel to fill available positions.
Selecting and appointing personnel from suitable applicants.
Combining personnel into desired configurations by unit and shift.
Orienting personnel to fulfil assigned responsibilities.
Assigning responsibilities for client services to available personnel.

4. 4
Nature of Staffing
People centered
Responsibility of Every Manager
Human Skills-Training
Continuous function

5. 5
Steps of Staffing
Determinethenumberandtypesofpersonnelneededto
fulfilthephilosophy,responsibilitiesoftheorganization
Recruitandassignpersonnelbasedonestablishedjob
description.
Useorganizationalresourcesforinductionand
orientation
Ascertainthateachemployeeisadequatelysocializedto
organizationalvaluesandunitnorms.
Usecreativeandflexibleschedulingbasedonpatient
careneedstoincreaseproductivity.
Developaprogramofstaffeducationthatwillassist
employeesmeetingthegoalsoftheorganization.

6. 6
Philosophy of staffing in Nursing
Nurseadministratorsofahospitalnursingdepartmentmight
adoptthefollowingphilosophy.Nurseadministratorsbelieve
that
1.Itispossibletomatchemployee‘sknowledgeandskillsto
patientcareneedsinamannerthatoptimizesjobsatisfaction
andcarequality.
2.Thetechnicalandhumanisticcareneedsofcriticallyill
patientsarecomplexthatallaspectsofthatcareshouldbe
providedbyprofessionalnurses.
3.Thehealthteachingandrehabilitationneedsofchronically
illpatientsaresocomplexthatdirectcareforchronicallyill
patientsshouldbeprovidedbyprofessionalandtechnical
nurses.

7. 7
Shouldbelievethatpatientassessment,andjob
analysistobeassignedforpatientsofeachtype
(suchascoronarycare,renalfailure,etc.,).
shouldbelievethatamasterstaffingplanand
policiestoimplementtheplaninallunits
shouldbedevelopedcentrallybythenursing
headsandstaffofthehospital.
Staffingplanshouldbeadministratedattheunit
levelbytheheadnurse,sothatcanchange
basedonunitworkloadandworkflow.

8. 8
Objectives of Staffing in Nursing
Provideprofessionalnursingstaffinallunits
Providesufficientstafftopermita1:1nurse-patientratio
foreachshiftineverycriticalcareunit.
Providesufficientnursingstaffingeneralmedical,
surgical,obstetric,pediatricandpsychiatricunitsto
permita1:5nurse-patientratioonadayandafternoon
shiftsand1:10nurse–patientratioonthenightshift.
Involvestheheadofthenursingstaffandallnursing
personnelindesigningthedepartmentoverallstaffing
programme.

9. 9
Empowertheheadnursetoadjustwork
schedulesforunit.
Informeachnursingemployeethatrequestfor
specificvacationholidaytimewillbehonored
withinthelimitsimposedbypatientscareand
laborcontractrequirements.
Rewardemployeesforlongtermservicesby
grantingindividualsspecialtimerequestsonthe
basisofseniority.

10. 10
Staffing Study
Astaffingstudyshouldgatherdataaboutenvironmental
factorswithinandoutsidetheorganization.
Aydelottelistedfourtechniquesdrawnfromengineering
tomeasuretheworkofnurses,allofwhichinvolvethe
conceptoftimerequiredforperformance.
Timestudyandtaskfrequency
Worksampling
Continuoussampling
Self-reporting

11. 11
Staffing Norms
Normsarestandardsthatguide,control,andregulate
individualsandcommunities.
Forplanningnursingmanpowerwehavetofollow
somenorms.
Thenursingnormsarerecommendedbyvarious
committees,suchas;theNursingManPower
Committee,theHigh-powerCommittee,Dr.Bajaj
Committee,andthestaffinspectioncommittee,
TNAIandINC.

12. 12
Alltheabovecommitteesandthestaff
inspectionunitrecommendedthenormsfor
optimumnurse-patientratio.
Suchas1:3forNonTeachingHospitaland1:5
fortheTeachingHospital.
TheStaffInspectionUnit(S.I.U.)istheunit
whichhasrecommendedthenursingnormsin
theyear1991-92.
AsperthisS.I.U.normthepresentnurse-patient
ratioisbasedandpracticedinallcentral
governmenthospitals.

13. 13
Recommendations of SIU
Thenormstakenintoaccounttheworkloadprojectedinthe
wardsandtheotherareasofthehospital.
Thepostsofnursingsistersandstaffnurseshavebeen
clubbedtogetherforcalculatingthestaffentitlementfor
performingnursingcareworkwhichthestaffnursewill
continuetoperformevenaftersheispromotedtothe
existingscaleofnursingsister.
Outoftheentitlementworkedoutonthebasisofthenorms,
30%postsmaybesanctionedasnursingsister.Thiswould
furtherimprovetheexistingratioof1nursingsisterto3
staffnursesfixedbythegovernmentinsettlementwiththe
DelhinurseunioninMay1990.

14. 14
The assistant nursing superintendent are recommended in the ratio of 1
ANS to every 4.5 nursing sisters. The ANS will perform the duty presently
performed by nursing sisters and perform duty in shift also.
The posts of Deputy Nursing Superintendent may continue at the level of
1 DNS per every 7.5 ANS
There will be a post of Nursing Superintendent for every hospital having
250 or beds.
There will be a post of 1 Chief Nursing Officer for every hospital having
500 or more beds.
It is recommended that 45% posts added for the area of 365 days working
including 10% leave reserve (maternity leave, earned leave, and days off
as nurses are entitled for 8 days off per month and 3 National Holidays
per year when doing 3 shift duties).

15. 15
1.General Ward
2. Special Ward)
1:6
1:4
3.Nursery 1:1(Nothing mentioned about the
shifts)
4.I.C.U. 1:l per table
5.Labour Room Major -1 :2 per table
Minor -1:l per table
6.O.T. 1:1(Nothing mentioned about the
shifts)
7.Casualty-
a. Casualty main attendance up to
100 patientsper day thereafter
b.forevery additional attendance of
35 patients
c.gynae/ obstetric attendance
d.thereafter every additional
attendance of 15 patients.
3 staff nurses for 24 hours, 1:1per shift.
1:35
·3 staff nurses for 24 hours, 1:1/ shift
1:15

16. 16
8.Injection room OPD Attendance upto100 patients per day 1 staff nurse
120-220 patients: 2 staff nurses
221-320 patients: 3 staff nurses
321-420 patients: 4 staff nurses
9.OPD
NAME OF THE DEPARTMENT
·Blood bank
·Paediatric
·Immunization
·Eye
·ENT
·Pre anaesthetic
·Cardio lab
·Bronchoscopy lab
·Vaccination anti rabis
·Family planning
·Medical
·Dental
·Central sample collection centre
·Orthopaedic
·Gyne
·Xray
·Skin
·V D centre
·Chemotherapy
·Neurology
·Microbiology
·Psychiatry
·Burns
1
2
2
1
1
1
1
1
1
2
1
1
1
1
2
2
3
2
2
2
1
2
1
2

17. 17
Norms of TNAI and INC
Chief Nursing Officer :1 per 500 beds
Nursing Superintendent:1 per 400 beds or above
D.NS. :1 per 300 beds and 1 additional for every 200 beds
A.N.S. :1 for 100-150 beds or 3-4 wards
Ward Sister :1 for 25-30 beds or one ward. 30% leave reserve
Staff Nurse :1 for 3 beds in Teaching Hospital in general ward&1for 5
beds in Non-teaching Hospital +30% Leave reserve
Extra Nursing staff to be provided for departmental research function.
For OPD and Emergency:1 staff nurse for 100 patients (1 : 100 ) + 30%
leave reserve
For Intensive Care unit: (I.C.U.)-1:l or (1:3 for each shift ) +30% leave
reserve.
It is suggested that for 250 bedded hospital there should be One Infection
Control Nurse (ICN).

18. 18
Patient Classification System
Patientclassificationsystem(PCS)
,whichquantifiesthequalityofthe
nursingcare,isessentialtostaffing
nursingunitsofhospitalsandnursing
homes.
TheprimaryaimofPCSistobeable
torespondtoconstantvariationinthe
careneedsofpatients.

19. 19
Purposes
Thesystemwillestablishaunitofmeasurefor
nursing,thatis,time,whichwillbeusedto
determinenumbersandkindsofstaffneeded.
Programcostingandformulationofthenursing
budget.
Trackingchangesinpatientscareneeds.
Determiningthevaluesoftheproductivity
Determinethequality

20. 20
THANK YOU