SIGNIFICANCE OF
STAFFING
“TOO FEW WORKERS IS BETTER THAN
TOO MANY. ONE PERSON WITH HALF A
JOB CAN WANDER AROUND AND DO
REAL DAMAGE IN SPARE TIME”.
ROBERT TOWNSEND
DEFINITION
The process of planning , employing
and developing human resources at
different levels of an organization
for carrying out the various
managerial and other functions
required.
DEFINITION
Staffing is a selection, training, motivating,
and retaining of a personnel in the
organisation.
PHILOSOPHY OF STAFFING
Knowledge and skill of the staff can fulfill the
needs of patient to ensure both job
satisfaction and quality care.
Only professionally trained nurses can
provide high quality care by providing both
technical and intrapersonal skills.
Instead of providing quality care , a
professional nurse also provide health
Patient assessment, work qualification and job analysis should
be used to determine the number of personnel in each category
for each type of patients – coronary care,renal failure, arthritis
etc.
A master staffing plan and policies to implement the plan in all
units should be developed centrally by the nursing heads and
staff of the hospital.
A staffing plan should be delegated to each unit -level head
nurse so that activities and details of each shift are planned well.
FUNCTIONS OF STAFFING
6. UTILIZATION
OF RESOURCES
5. MAKES STRONGER
ORGANISATION
4. EFFICIENT HUMAN RESOURCE
3. ORGANISATIONAL PERFORMANCE
2. MANAGERIAL FUNCTIONS
1. ACHIEVE THE OBJECTIVE
Determinants of staffing needs
1. The work load of the unit.
2. Percentage of occupancy
3. Average length of stay
4. Staffing budgeting.
Work load of the unit
The number of admissions for the day.
The over all number of available patient
beds.
The number of occupied beds for the
period.
The number of patient days for the unit.
CONTD.
Occupancy level presented as both monthly and
year-to- date data.
Average daily census for the unit.
Average acuity for the patient on the unit.
Percentage of occupancy
Another way of assessing a unit’s activity level is by the
percentage of occupancy, which is calculated by dividing
the patients census by the number of beds actually
occupied.
e.g if a unit has 38 beds and 37 of those beds are
occupied, the average occupancy is 37÷38=0.974 or
97.4%
Average length of stay
Changes in the way hospitals and agencies are
reimbursed by third party payers has resulted in a focus
on the length of stay. Length of stay has decreased, as
has the reimbursed amount. The cost of treating the
patient has not decreased as dramatically because the
patient acuity is greater, essentially we need to do more
in less time with the same.
Staffing budget - FTE
Unit budgets are calculated by projecting how many full
time equivalents will be needed. And FTE is an employee
who works forty hours per week for 52 weeks per year, or
2080 hours. This is based on the accepted standard of an
eight hour day for 5 days per week.
STAFFING STUDY
Staff study accumulate information regarding
environmental elements both within and
outside the organization .
AYDELOTTE has made a list of 4 techniques
to evaluate the work of nurses.
These techniques involve the concept of time
needed for a performance .
AYDELOTTE TECHNIQUES
TECHNIQUE DESCRIPTION
1. Time study and task Avg. time
Sample size
frequency
Standard time*frequency
of task= volume of work
Task and task elements
Point and time started
Point and time ended
Allowance for personal
variation, unavoidable
standby and fatigue.
TECHNIQUE DESCRIPTION
2. Work sampling Recognize nursing
activities.
Find out the no: of
observations to do.
Determine random
sample of staff who are
executing the policies.
Study the
observations.
TECHNIQUE DESCRIPTION
3. Continuous sampling Observer follows one
individual in the
performance of work.
Observer may check
work carried out for
one/more pts. If they
can be observed at the
same time.
TECHNIQUE DESCRIPTION
4 . Self reporting The individual records the
work sampling or
continuous sampling on
himself or herself.
The task is documented
using task start and end
data and intervals and time.
Logs are examined.
NORMS AND ACTIVITIES
RECOMMENDATIONS OF STAFF INSPECTION
UNIT (SIU):
Norms have taken into account the workload in
wards and other areas.
A staff nurse will continue to perform same
duties even after promotion to nursing sister.
Out of the entitlements worked out on the basis
of norms, 30% posts are sanctioned for nursing
sisters.
ANS are recommended in the ratio of 1 ANS to
every 4.5 nursing sisters.
The post of DNS may continue at the level of 1
DNS to every 7.5 ANS.
There will a post of NURSING
SUPERINTENDENT (NS) for every hospital with
250 beds.
There will be a post of CHIEF NURSING
OFFICER(CNO) for every hospital with 500/more
beds.
It is recommended that 45% posts added for
the area of 365 days working including 10%
leave reserve .
Normal Wards : 1 Staff Nurse/Nursing Sister
for every 6 beds.
Special Wards : 1 Staff Nurse/Nursing Sister
for every beds
NURSE-PATIENT RATIO
AS PER( TRAINED NURSE’S ASSOCIATION OF
INDIA ) and( INDIAN NURSING COUNCIL)
CNO: 1 for 500 beds
NS: 1 for 400beds
DNS: 1 for 300 beds and 1 additional for
every 200 beds
ANS: 1 for 150 beds or 3-4 wards
WARD SISTER: 1 for 25-30 beds or one ward
STAFF NURSE: 1 for 3 beds in general ward in
teaching hospitals and 1 for 5 beds in non
teaching wards.
`
Extra nursing staff to be provided for
departmental research function.
OPD and EMERGENCY: 1 staff nurse for 100
patients
ICU: 1:1 or 1:3 for each shift
There should be 1 INFECTION CONTROL
NURSE for 250 bed hospital .
PATIENT CLASSIFICATION SYSTEM
(PCS)
This system groups patients as per the
complexity and amount of their nursing care
necessities.
TYPES OF PCS
• FACTOR EVALUATION SYSTEM
1
• COMMON CARE DESCRIPTON1`
2
• DIAGNOSTIC RELATED GROUPS
3
FACTOR EVALUATION SYSTEM
In this, several care elements or descriptors are
identified .
Each element divided into subelements and
standard time is determined to accomplish each
subelement.
The descriptors used to measure a patient’s
dependency needs are ADLs.
The requirement to assist a patient is quantified
from least to the greatest amount of time required
(e.g. self feeding versus tube feeding).
COMMON CARE DESCRIPTOR
It describes typical patients and their varying need
level
After selecting descriptor , levels of care and
intensity are defined and each level is differentiated
by amount of time and frequency it requires.
The factor system can be cited as objective because
mentioning special indicators or factors with patient
care facilities to ascertain the objectivity by the
rater .
The prototype evaluation system regarded as
subjective . It uses categories to report the patient
and his requirements .
CATEGORIES
CATEGORY : I Patient with acute,
episodic
disease/disability and
for whom the aim is to
relieve health problem.
Patient with chronic
CATEGORY : II
disease & potential to
return to pre-episodic
level of functioning
where the health
problem is managed by
self/ family.
CATEGORY : III Patient with chronic
disease & who return
to preillness with
potential to increase
the level of functioning
with care. The goal is
rehabilitation with
agency support.
CATEGORY : IV Patient with chronic
disease who can’t be
maintained at home
without agency
support.
CATEGORY : V Patient with end stage
of illness.
DIAGNOSTIC RELATED GROUPS
(DRGs)
Grouping patients for prospective payments.
This system sets a predetermined price for
patient hospital care of medicare recipients
according to the patient’s placement in one of
467 DRGs.
It is a strategy for grouping patients according
to demographic , diagnostic and therapeutic
characteristics that correlate with their use of
hospital facilities.
This system provides incentives for early
hospital discharge but the quality of care is
DUTY ROSTER
Scheduling or preparing the duty roster is
defined as making patterns of on-off duty
hours for employees in a particular unit.
Patterning of working and non-working hours
directly affect the employee’s productivity,
work satisfaction and job tenure.
STEPS IN PLANNING
DUTY ROSTER
A skeleton plan is made in pencil to allow
alterations.
List the names in order of seniority.
Put special requests in ink to avoid eraser.
Insert days off , noting busier days . It is important
not to have too many nurses off duty at same time.
When placing days off in schedule , refer to previous
roster so that days off are reasonably spaced and
weekend offs are shared.
Add the shifts , balancing senior and junior nurses ,
ensuring that there is a senior nurse on duty to take
charge and trained nurses are evenly distributed.
Total the number of staff on duty for each shift.
The roster may be planned weekly or it may be fixed
one.
All the above steps can be modified
based on the policies of each
organization to suit its working
conditions.
GUIDE TO COMPILING ROSTER
(PART – A)
Use the roster sheet as provided by health agencies.
Don’t cut sheets, always use full size and fill one
sheet before going on to a new one.
Compile the roster for one full calendar month in
advance.
Fill in headings: name of department, month, dates,
days of week.
Rule lines in red to divide into complete weeks, (e.g.
from Saturday of the previous week to Friday of the
following week).
Write full names and designation of each staff
member in the left -hand column.
Ensure that names of all staffs , including those on
leave and new members, are recorded accurately.
When staff leaves the department through
transfer/resignation, draw two lines in red through
the remaining days of the month, indicating the
new department, or resignation, or end of contract.
Enter leave by ruling a line between the agreed
dates . (e.g. 30 days AL + 45 days ML :
15. 12.2007 -27.02.2008 ).
Use accepted symbols only .
GUIDE TO COMPILING ROSTER
(PART – B)
Before starting , check request book for any special
requests.
All shifts M (morning), A (afternoon), N (night) should
be written in blue felt pen.
DO (day off), PH (public holiday) should be written in
top right corner, e.g. PH6 etc.
Asterisk (*) the name of the staff nurse in charge of
each shift .
Count numbers on each shift according to grade ,
total and record on the roster .
Duty roster should be submitted to the NS for
checking and approval one week before it comes into
Staff who resign at any time during the year are only
entitled to the number of PHs occurring up to the
date of resignation.
Copy the completed roster, checked and signed by
the ward in charge and nursing officer , is to be
submitted to the nursing administration not later
than the 26th /27th day of each month .
THANK
YOU
