ESTIMATING OF NURSING STAFF

REQUIREMENT – Activity Analysis

PRESENTED BY
MRS HEENA MEHTA
S. Y. M.Sc. Nursing
 INTRODUCTION
• Staffing is one of the major problems of any nursing
organizations whether it to be a hospital, home health
care agency, or another type of facility.
• Nurse staffing methodology should be an orderly,
systematic process, based upon sound rationale,
applied to determine the number and kind of nursing
personnel required to provide the nursing care as per
the standards of nursing practice to a group of patients
in a particular sense.
 INTRODUCTION
• The end results is the prediction of the kind
and number of staff required to give care of
patients. In practice the terms staffing and
scheduling are sometimes used
interchangeably.
• Although they are closely related as the two
sides of a coin there are practical differences
as follows:
 INTRODUCTION
• Staffing is determining how many people of
what specific skills are needed and make them
available
• Scheduling is determining
who,
by name and skill ,
will do what work and
when (specific time period)
 MEANING
• Staffing as largely a part of organizing,
establishing the framework within which the
work will get done, while scheduling is
essentially a refined component of planning.
• The concept of good staffing determines and
provides the acceptable number of personnel
to produce a desired level of care to meet the
patient’s demand of care
 MEANING
• When the demand of patients needs increases
or decreases in a ward. It is necessary to
reassign nurses to balance the staff as per
needs.
• The dynamic staffing and allocation process is
accomplished by taking staff from one ward to
another or by posting extra nurses on
relieving duty.
• Allocation provides information to adjust the
scheduled staff to meet daily workload
demand of each unit.
• This component is concerned with the
balancing of staff to fluctuation of work load
among similar nursing units through
personnel allocation and selective patient’s
placement.
 ALLOCATION
• Appropriate selection of staff in the
departments according to their capabilities
would help nurses to provide efficient
nursing care to the patient.
 Objectives of Allocation Procedure
• The objectives of allocation procedure is to
reassign working days and days off to nursing
staff so that:
• To provide quality patient care
• To avoid over staffing or under staffing in a unit
and
• To facilitate a desirable distribution of day off for
nursing personnel
 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.
 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
 FACTORS
AFFECTING
ALLOCATION
PROCESS
 Allocation procedure
• Patient’s classification system does not measure the
amount of care required by patients.
• However the category of patient fails within the unit
can be correlated with the total amount of nursing
care required by that patient.
• The result of patient classification and measurement of
nursing services provided are combined to obtain the
hours and minutes of direct patient care for each class
of patient for each shift during the period of
observation
 Allocation procedure
• The total minutes or hours of care for any population
of patients in unit can be arriving at the services
required for the given number of patients. The
estimated workload is presented in terms of the total
amount of care required.
• A workload sheet is used to calculate the mean
number of nursing hours required in that unit.
• Various methods are adopted to classify the patients
and to assess nursing hours needed by per day by each
category of patients.
• Following is an example of nursing care conducted
by college of nursing, Delhi and T.N.A.I..
Accordingly patients are classified under 3
categories:
• Completely dependent

• Partially dependent

• Ambulatory
 Allocation procedure
Goddard’s classified the patient’s dependency
into 5 categories:
• Totally ambulant
• Partially bed fast
• Bed fast but not helpless
• Partially helpless
• Totally helpless
 Another classification system
presented by E.A. Schmied
• A patient who requires only minimal amount of
nursing care (an average of 2.8 nursing hours per 24
hours)
• A patient who requires average amount of nursing
care (an average of 4.3 nursing hours per 24 hours)
• A patient who requires above average nursing care (an
average of 5.6 nursing hours per 24 hours)
• A patient who requires maximum nursing care (an
average of 8.6 nursing hours per 24 hours)
• According to the study conducted in college of
nursing, Delhi, the nursing hours needed by per
category of patient in 24 hours assessed as given
below:
Category of Morning Shift Evening Shift Night Shift Total
Patient
I Completely 3.27 2.50 1.47 7.24
Dependent
II Partially 1.62 0.91 0.55 3.08
Dependent
III Ambulatory 1.20 0.70 0.17 2.07

6.09 4.11 2.10 12.29

• Now, we will learn how to allocate nurses in each unit.
Suppose a ward having 30 patients in which 10
patients are ambulatory, 15 patient’s partially
dependent and 5 patients are completely dependent.
• There are 3 equal hours shift duty and we need to
allocate nurses for 24 hours. We know work load as
well as classification of patients. It is very simple to
calculate. The following table is self explanatory to the
known method of calculation:
Category of Daily average Total patient Calculation per Total
patient time per patient category of
in 24 hours patient

I 7.24 5 7. 24 ×5 36.20
Completely
dependent
II 3.08 15 3.08 × 15 46.20
Partially
dependent
III 2.07 10 2.07 × 10 20.70
Ambulatory
patient
Total work load for 30 patients = 103 hours 103.10 hours
• Each nurse is expected to work = 8 Hrs/ day
• Total number of Nurses required = 103/8 = 13
• = 13 nurses approximately
• Provision of day off, Casual leave, Earned leave
and other permitted Gazetted about 116
days/year. To meet leave vacancies extra nurses
required;
• = 116/365 ×103/8
• = 4.09 nurses
• Total nurses required = 13 + 4 = 17 Nurses.
• When we know the total number of allocation
we must also know to calculate the number of
nurses required in each shift.
• We have already been acquainted with
nursing hours requirement per patient per
category per shift.
• We have 30 patients and we have 17 nurses at
our disposal. Let us learn the calculation from
the given below:
Category of patient Morning shift Evening shift Night shift nursing
nursing hours nursing hours hours
I 5 completely 3.27 ×5 = 16.35 2.5×5=12.50 1.45×5=7.25
dependent
II 15 Partially 1.62×15 = 24.30 0.91×15 = 13.65 0.56 ×15= 8.40
dependent patients

III 10 Ambulatory 1.2×10 = 12.00 0.7×10 = 7 0.17 ×10 = 1.70

Total Nursing units 52.65 33.15 17.35

time in each shift
Hrs
Total = 103.15 Hours
• Staff requirement in each shift according to
workload in each shift
• Staff in morning shift = 52.65 ×13/103.15= 7
• Staff in evening shift = 33.15 ×13/103.15 = 4
• Staff in night shift = 13 – (7+4) = 2
• So we have to allocate 7 nurses in morning
shift, 4 in evening and 2 in nigh shift
•HAVE ANY
QUESTION?
 CONCLUSION
• In the above method we have seen that in order
to allocate nurse in each unit, we have
acquainted with several approaches. The first
approach is an empirical approach in which the
supervisor or head nurse requests a certain
number of personnel according to how many
nurses she thinks are necessary to perform the
work in that unit. This approach does not
provide a ratio of professional to non-
professional persons.
• A second approach is based on the nursing
hours required by each category of personnel
in each shift in 24 hours. Nursing care hours
are based on total number of patients in
each category. Again no set standard for
nursing hours are available
• Activity analysis or task analysis of each
person and how long he does each task is
another approach to allocate nurses. A work
load index is used as an approach for
allocation of nurses in wards, This is based
on a realistic evaluation of patient care
requirements:
• The ward sisters must send census report of
their unit daily to nurse administrator along
with the types of patients admitted in their
unit. It gives an idea of census fluctuations,
patient classification problems, in
appropriate staffing in that unit and other
variances. It gives a clue for forecasting need
of nursing personnel monthly and yearly
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T H A N K YO U