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Staffing Needs and Scheduling Policies

The document discusses various methods for determining staffing needs and developing scheduling policies for nursing units. It examines factors like nurse-patient ratios, different shift structures, use of supplemental staff, workload measurement tools, and generational considerations. Solutions discussed for addressing nursing shortages include advanced planning, cross-training staff, closed-unit staffing models, and mandatory overtime.

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Erika Mae
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788 views30 pages

Staffing Needs and Scheduling Policies

The document discusses various methods for determining staffing needs and developing scheduling policies for nursing units. It examines factors like nurse-patient ratios, different shift structures, use of supplemental staff, workload measurement tools, and generational considerations. Solutions discussed for addressing nursing shortages include advanced planning, cross-training staff, closed-unit staffing models, and mandatory overtime.

Uploaded by

Erika Mae
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Staffing Needs and Scheduling

Policies
Objectives

 To examines different methods for determining staffing


needs,
 To identify communicating staffing plans.
 To develop and communicate scheduling policies.
 To discuss Unit fiscal responsibility.
 To explain formulas and instructions for calculating daily
staffing needs.
Staffing

 In staffing the leader-manager recruits, select, &


promote personnel development for accomplish the
goals of organization.

 also ascertain that adequate numbers & an appropriate


mix of personnel are available to meet daily units needs
Definitions

 Staffing: its human resources planning to fill position in an


organization with qualified personnel.

 Scheduling: It's on going implementation off staffing


pattern by assigning individual personal to work specific
hours & days in a specific unit or area
Unit manager responsibility in meeting
staffing needs

 Inflexibility scheduling is major contributor to job


dissatisfaction to nurses.

 Many organization use computers to assist with staffing.

 Its major function of first & middle level manager.


Nurse/patient ratio
 Identifying and maintaining the appropriate number and mix of nursing staff is
critical to the delivery of quality patient care.

 Numerous studies reveal an association between higher levels of experienced


RN staffing land lower rates of adverse patient outcomes.

 Adequate ratio has the following benefit:


 Reduce medical and medication errors
 Decrease patient complications
 Decrease mortality
 Improve patient satisfaction,
 Reduce nurse fatigue
 Decrease nurse burnout
 Improve nurse retention and job satisfaction
Example
Decentralize staffing:
 The unit manager is often responsible for covering all
scheduled staff absences.

 Advantages:
1. Unit managers understand the needs of unit & staff , staffing
decisions will be made.
2. Staff feels more in control of their work environment .
3. Leads to increased autonomy & flexibility, it decreases nurse
attrition.
 Disadvantages:
1. Some staff members may receive individualized treatment at
the expense of others.
2. Work schedules can be used as a punish-reward system.
Centralize staffing
 Staffing is made by personnel in central office or staffing
center.
Advantages :-
1. It's fairer to all employees impartially.
2. It frees middle-level manager
3. It allows for the most efficient (cost effective….why?)

Disadvantages:-
1. Does not provide much flexibility for workers.
2. Manager have limited responsibility in scheduling.
Staffing & Scheduling Options

•10- or 12-hour shifts


•Premium pay for weekend work
•Part-time staffing pool for weekend shifts and holidays
•Cyclical staffing
• Job sharing
•Allowing nurses to exchange hours of work among themselves
•Flextime
•Use of supplemental staffing from outside registries and float pools
•Staff self-scheduling
10-12 hour shift:

 may require overtime pay, the resultant nurse


satisfaction must be weighed against the increased
costs.

 Additionally, extending the length of shifts may result in


increased judgment errors as nurses become fatigued.

 For this reason, many organizations limit the number


of consecutive 10- or 12-hour days a nurse can work or
the number of hours that can be worked in a given day.
Eight hour shift in a five day workweek

 5-day, 40-hours workweek

 The shift usually 7am to 3:30pm, 3pm to 11:30pm, and


11pm to 7:30 am and a half hour overlap time between
shifts to provide continuity of care.
Alternating or rotating work shifts

 Some nurses may work all three shifts within 7 days.

 Create stress for staff nurses.

 Body rhythms need time to adjust to the discrepancy


between the persons activity cycle and the new
demands of the environment.
Cont.

 The ability of the body functions to adjust varies


considerably among individuals. It may take 2-3 days to
2 weeks for a person to adjust to a different sleep-wake
cycle.

 it effect the health of nurses and the quality of their


work. Anorexia, digestive disturbances, disruption in
bowel habits, fatigue, and error proneness.
Permanent shift

 Advantages:

 1. Permanent shift relieve nurses from stress and health


related problems associated with alternating and
rotating shifts.

 2. provide social, educational, and psychological


advantages.

 3. staff can participate in social activities.


Disadvantages:

 Managers may have difficulty in evaluating the evening


and night shifts.

 The staff of permanent shift not develop an appreciation


for the workload or problems of other shifts.
Block, cyclical, scheduling

 Block, or cyclical, scheduling uses the same schedule


repeatedly. The schedule repeat itself every 6 weeks.

 Advantages:
 personnel know their schedules in advance and
consequently can plan their social live.
 Absenteeism will be less.
 establish stable work groups and decrease floating, thus
promoting team spirit and continuity of care.
Supplemental nursing staff

 These nurses are usually work for premium pay (often


two to three times that of a regularly employed staff
nurse), without benefits.

 While such staff provide scheduling relief, especially in


response to unanticipated increases in census or patient
acuity.

 Their continuous use is expensive and can result in poor


continuity of nursing care.
Flextime

 Or self-scheduling is a system that allows employees to


select the time schedules that best meet their personal
needs while still meeting work responsibilities.

 When a hospital uses flextime, units have employees


coming and leaving the unit at many different times.

 Although flextime staffing creates greater employee


choices, it may be difficult for the manager to
coordinate and could easily result in overstaffing
or understaffing.
Advantages

 It offer nurses greater control over their work


environment,
 it provides greater worker participation in decision
making,
 it save time, improve morale & professionalism &
reduces personnel turnover
Nursing Rotation

 Nursing rotation is a period in which a nurse in the work in other


units other than his original unit for 4-6 month blocks.

 Advantages:
1. Getting new experiences.
2. decrease the sense of boredom.

 Disadvantages:
1. Create stressful time for the nurse.
2. Nurse need time to become competent in his new unit.
Staffing to meet fluctuation needs/
adjustment to workload

 Transfer staff from a less busy area to the overloaded


area.

economical to the agency, but disrupts the unity of


work groups, causes transferred nurse to feel insecure,
and contributes to job dissatisfaction and turnover.
Some units require specialized knowledge and skill
that not every nurse has(cross training is helpful).

 Companion floor system, two units relieve each others.


Workload measurement tools

1. NCH/PPD: A formula for calculating nursing care hours


per patient day. NCH/PPD = Nursing Hours Worked in 24
Hours/Patient Census

 its simplest use, use widely, all nursing & ancillary staff are
treated equally for determining hours of nursing care &
no differentiation is made for differing acuity levels of
patient .

 These two factors alone may result in an incomplete or


even inaccurate picture of nursing care needs.
Example:

 11PM- 7AM (4 staff) = 32hrs


 7AM- 3PM (7 staff) = 56hrs
 3PM- 11PM (6 staff) = 64hrs
________
136 hours/25 patients = 5.44 NCH/PPD
Patient Classification Systems (PCS)

 Also known as workload management ,or patient acuity tools


,were developed in the 1960s.

 PCSs group patients according to specific characteristics that


measure acuity of illness in an effort to determine both the
number and mix of the staff needed.

 Because other variables within the system have an impact on


nursing care hours, it is usually not possible to transfer a
patient classification system from one facility to another.
It can classify as either:

 A. Critical indicator
 It used broad indicator such as bathing, diet, I.V fluids &
medication.

 B. Summative type:-
 The summative task requires the nurse to note frequency
of occurrence of specific activities, treatment &
procedures for each patient.
Generational Consideration for Staffing:
1. Veteran generation: (Those nurses between 1925-1942, have lived
in several military conflict) they respect authority, work in more
structured, support hierarchy.

2. Boom generation:(Those between 1943-1960) have more traditional


work values, willing to work long hours, flexible, independent and
creativity.

3. X generation: (1961-1981) more flexible part time and 12 hours shift.

4. Y generation: (1978-1981) seek roles that will push their limits; they
are optimistic, self –conflict.
Solution for nursing shortage

 Advanced planning and recruitment

 Cross-training: giving personnel with varying educational


backgrounds and expertise the skills necessary to take
on tasks normally outside their scope.
Cont.

 Closed-unit staffing -occurs when the staff members on


a unit make a commitment to cover all absences and
needed extra help themselves in return for not being
pulled from the unit in times of low census.

 Mandatory overtime, employees are forced to work


additional shifts, often under threat of patient
abandonment, should they refuse to do so. Some
hospitals routinely use mandatory overtime in an effort to
keep fewer people on the payroll.

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