POLYTECHNIC COLLEGE OF DAVAO DEL SUR

Mc Arthur Highway, Kiagot Hights, Digos City

In Partial Fulfillment of the Requirements in

Nursing Care Management 107

A MINI TERM PAPER ON

S T A F F I N G

Presented to:
Mr. Rolando Oroc, RN

Presented by:
John Daemer H. Kinoc

August 27, 2011

A. PLANNING

-is defined as pre determining a course of action in order to arrive at desired results. It is
continuous process of assessing goals and objective, implementing and evaluating them,
and subjecting these to change as new facts are known

IMPORTANCE OF PLANNING

Nurse Managers should know how to plan for several reasons.

1. Planning is a cost effective. Cost can be controlled planning for efficient operation. For
example. Projecting the number of operations in a given day, including daily dressings,
helps in determining accurately the needed weekly supplies in the surgical units so as to
prevent undersupply or pilferages.

2. Planning helps in coping with crises. hospitals should for provide for disaster plan,
these allows the workers to function more clearly and efficiently when actual
emergencies occur such as fire, typhoons, earthquake, or during new year celebrations
and or other occasions when more people are likely to get hurt.

3. Planning provides foe effective use of available resources and facilities. The best use of
personnel and material resources prevent wastage. Workers experience greater
satisfaction if what they do becomes meaningful to them.

4. Planning leads to achievement of goals and objective. Workers relate what they do
meaningful results since plans are focused on object.

5. Planning make meaning to work .Employee or workers experience greater satisfaction

if what they do becomes meaningful to them.

6. Planning is based on past and future activities. Evaluation of programs, schedules, and
activities whether successful or not. Prevents and or reduces the recurrence of problem
and provide better ideas in modifying or avoiding them.

7. Planning leads to the realization of the need for change. many hospitals have found
out than in patient hospital days can greatly be reduced by having the laboratory and
diagnostic work-up in the in the unit pt.minor surgeries are also done at the pt.
 department so the more hospitals beds cab be allotted to critically ill p. of for those
needing specialized services.

8. Planning is necessary for effective control. Nurse Managers evaluate the environment
or setting in which they work where the patient are confined and make necessary
recommendations to make hospital conditions more therapeutic not only for the pt. but
for the workers as well.

PHASES OF PLANNING PROCESS

David Allen says, regardless of task size, the human brain goes through what he calls a
Natural Planning Model. These are five phases our brain works through when
accomplishing tasks. He goes on to say that we should use this natural model when
planning projects.

The five phases:

1. Defining purpose and principles – Here’s where we ask “Why?” Answering this question
defines the successful outcome, sets the boundaries, as well as focusing and motivating
towards completion. You need to know where you’re going before you can plot the
course.

2. Outcome visioning – Allen says, if you can’t visualize the end result you will have
trouble figuring out how to do it. He suggests going beyond mere completion and
visualizing what “wildly successful” would look like.

3. Brainstorming – Brainstorming generates the ideas for moving the project to

completion. Allen recommends getting the ideas out of the head and onto paper.
Writing serves to clear the mind enabling other ideas to come through. Writing also
helps keep the focus on the project at hand.

4. Organizing – Now that those ideas are out of your head and onto paper, start moving
them around. Figure out which are the important pieces and sort by components,
sequences and priorities.

5. Identifying next actions – Of course, no planning would be complete until Next Actions
have been identified. What is the immediate action required to move the project
forward on every front.

David Allen says this about the five phases, “Worked together, they create a whole
model of how we get things done most effectively, with the least amount of effort. If any
one of the five steps is done insufficiently, however, effectiveness can be severely limited.”
B. STAFFING

-Staffing is a process of determining and providing the acceptable number and mix of
nursing personnel to produce a desired level of care to meet the patient’s demand.

FACTORS AND STEPS IN DETERMINING STAFFING NEEDS:

 The type, physiology, objective of the hospital and the nursing service
 the population served or the kind of patients served wither pay or charity
 the number of patient and severity of their illness- knowledge and ability of nursing
personnel are matched with the actual care needs of the patient
 availability and characteristics of the of the nursing staff, including education, level of
preparation, mix of personnel, number and position
 administrative policies such as rotation, weekends and holidays off- duties
 Standards of care desired which should be available and clearly spelled out. Institutions
may utilize the ANSAP’s Standard of nursing practice ;PRC-AMSAP,s Stabdars of State
Nursing practice and/ or the hospitals themselves may formulate/ develop their own
standards
 layout of the various nursing units and resource available within the department such as
adequate equipment, supplies and materials
 budget including the amount allotted to salaries, fringe benefits, supplies, materials and
equipment

FORMULA TO DETERMINE STAFFING NEEDS

The compute for the staff needed in the In- patient units of the hospital the following steps are
considered

1. Categorize the number of patient according to the level of care needed. Multiply the total
number of patient by the percentage of pt,s at each level of care (whether minimal ,
intermediate, intensive or highly specialized)

2. Find the total number of nursing care hours needed by the pt. at each category level.

a) Find the number of patients at each level by the average number of nursing care hours needed
per day

b) Get the sum of the nursing care hours needed at the various levels.

3. Find the actual number of nursing care hours needed by the given number of patients. Multiply
the total nursing care hours needed per day by the total number of days in a year.

4. Find the actual number of working hours rendered by each nursing personnel per day. Multiply
the number of hours on duty per day by the actual working days per year.

5. Find the total number of nursing personnel needed.

a) Divide the total unbar of nursing care needed per day by the actual number of working hours
rendered by an employee per year.

b) Find the number of relievers. Multiply the number of nursing personnel needed by 0.15(for
those working 40 hours per week)or by 0.12( for those working 48 hours per week)
 c) Add the number of relievers to the number of nursing personnel needed.

6. Categorize the nursing personnel into professionals and non – professionals. Multiply the
number of nursing personnel according to the ratio of professionals to non- professionals.

7. Distribute by shifts.

TO ILLUSTRATE:
Find the number of nursing personnel needed 250 patients in a tertiary hospital.

1. ) Categorize the patients according to level of care needed.

250(pts) x.30 = 75 patients needing minimal care

250(pts) x .45 = 112.5 patients needing moderate care

250(pts) x.15 = 37.5 patients need intensive care

250(pts) x. 01 = 25 patients need highly specialized nursing care

250

2. Find the number of nursing care hours (NCH) needed by patient at each level of care per day.

75 pts x 1.5 NCH needed at level I) = 112.5 NCH/day

112.5 pts x 3 (NCH needed al level 2) = 337.5 NCH/day

37.5 pts x 4.5 (NCH needed at kevel 3) = 168. 75 NCH/day

25 pts x 6 (NCH needed at level 4) = 150 NCH/day

Total 768.75NCH/day

3. Find the total NCH needed by 250 patients per year.

768.75 x 365 (day/ year) = 280,593.75 NCH/year

4. Find the actual working hours rendered by each nursing personnel per year.

8(Hrs/day) x 213 (working day/ year) = 1,704(working hours/year)

4. Find the total number of nursing personnel needed.

a) Total NCH per year = 280,593.75 =165

Working hours/year 1, 704

b) relief x total Nsg personnel = 165 x 0.15 = 25

c) total nursing personnel needed 165 + 25 = 190

5. Categorize the nursing personnel into professionals and non – professionals. Ratio of professionals
to non- professionals in a tertiary hospital is 65:35.

190 x .65 = 124 professional nurses

190 x .35 = 66 nursing attendants

7. Distribution by shifts

124 nurses x .45 = 56 nurses on AM shift

124 nurses x .37 = 46 nurses on PM shift

124 nurses x .18 = 22 nurses on night shift

 Total 124 nurses

66 Nsg attendants x .45 = 30 nursing attendants on AM shift

66 Nsg attendants x .37 = 24 nursing attendants on PM shift

66 Nsg attendants x .18 = 12 nursing attendants on night shift

Total 66 nursing attendants

C. BUDGET-IN UNIT

Preparing the budget

1. A budget is the annual operating plan. A financial “road map” and plan which
serves as an estimate of future cost and a plan for utilization of manpower,
material and other resources to cover capital project in the operating programs.

2. a nursing budget is a plan for allocation of resources based on preconceived

needs for a proposed series of programs to deliver patient care during one fiscal
year.

3. A hospital budget is a financial plan to meet future service expectations. These

expectations are derived from the best judgment translates these needs of the
community. Budgeting translates these needs to manpower, equipment and
supplies so the both service are provided at the highest level of quality at a
minimum cost.

4. A budget is simply a plan for future activities expressed in operational as well as

financial or monetary terms. In health care institutions, this consists of four
components – a revenue budget, an expenses budget, a cash budget, and a
capital budget.

a. revenue budget summarize the income which management expects to generate

during the planning period

b. Expense budget described the expected activity in operation and financial terms
for a given period of time.

c. Capital budget outlines the programmed acquisitions, disposals and

improvements in an institution’s physical capacity.

d. Cash budget represent the planned cash receipts and disbursements as well as
the cash balance expected during the planning period.

FACTORS IN BUDGET PLANNING

Nursing service needs are determined by many factors which the staff should be aware of as
budget planning proceeds. These are:

1. The type of pt. (medical, surgical. Maternity, pediatric, communicable dse. . Chronically ill),
length of stay in the hospital, and the acuteness’ of the illness;

2. the size of the hospital and its bed occupancy

3. The physical layout of the hospital, the size and plan of the wards or units, the Nurse’s station,
treatment rooms, etc.

4. personnel policies

a) salaries paid to various type of nursing personnel, including pay for overtime or shift differential
 b) the exact of vacation and sick leaves, holidays, and

c) provision for staff development programs including instructional staff

5. The grouping of patient such as those in specialized areas example ICU.

6. Standards of nursing care e.g the kind and amount of care to be given a it affects the number of
hours of bedside care.

7. the method of performing nursing care whether simple or complex;

8. the method of documentation;

9. the proportion of nursing care provided by professional nurses and those given by non
professionals

10. the amount and quality of supervision available and provided ;

11. the efficiency of job description and job classification;

12. The method of pt. assignment, whether functional , case, team or primary;

13. the amount and kind of labor- saving devices and equipment; intercommunication system;

14. the amount of centralized service provided: sterile supply, central oxygen service, linen supply;

15. the nursing service requirements of the ancillary departments: clinics, admitting office,
emergency rooms;

16. reports required be administration whether simple of complex; and

17. Affiliation of nursing students or medical students e.g inexperienced students need more
equipment and supplies.

D. DECISION MAKING

Most people who rise to the top of their chosen careers share a common
characteristic: they are decisive. They make decisions and are not afraid to take risks.
When it is time to do something, they do it, while others procrastinate and wait for
someone else to make the decision.
A decision is a course of action that is consciously chosen from available
alternatives for the purpose of achieving a desired result. It involves a choice utilizing
mental processes at the conscious level and is aimed at facilitating a defined objective.
Decisions made at the executive level are more complex and affect a greater
number of people. Decisions at the unit level usually pertain to everyday problems
which may have routine answers or which the Supervising Nurses and Head Nurses may
have learned to solve through experience. This method can be and must be learned and
developed through experience, practice and maturity.
 Previous researchers on the decision making process reveal that decision behavior is
quite complex and variable. The process itself can be described in five steps:
1. Definition of the Problem
2. Analysis of the problem
3. Development of an alternative solution
4. Selection of the solution
5. Implementation and follow-up

Logical decision making is an important part of all science-based professions, where

specialists apply their knowledge in a given area to making informed decisions. For
example, medical decision making often involves making a diagnosis and selecting an
appropriate treatment. Some research using naturalistic methods shows, however, that
in situations with higher time pressure, higher stakes, or increased ambiguities, experts
use intuitive decision making rather than structured approaches, following a recognition
primed decision approach to fit a set of indicators into the expert's experience and
immediately arrive at a satisfactory course of action without weighing alternatives.

E. CONFLICT MANAGEMENT

For any organization to be effective and efficient in achieving its goals, the people in the
organization need to have a shared vision of what they are striving to achieve, as well as
clear objectives for each team / department and individual. You also need ways of
recognizing and resolving conflict among people, so that conflict does not become so
serious that co-operation is impossible. All members of any organization need to have
ways of keeping conflict to a minimum - and of solving problems caused by conflict,
before conflict becomes a major obstacle to your work.
Conflict management is the process of planning to avoid conflict where possible
and organizing to resolve conflict where it does happen, as rapidly and smoothly as
possible.
Conflict management is often considered to be distinct from conflict resolution.
In order for actual conflict to occur, there should be an expression of exclusive patterns,
and tell why the conflict was expressed the way it was. Conflict is not just about simple
inaptness, but is often connected to a previous issue. The latter refers to resolving the
dispute to the approval of one or both parties, whereas the former concerns an ongoing
process that may never have a resolution. Neither is it considered the same as conflict
transformation, which seeks to reframe the positions of the conflict parties.