Fiscal Management in

Nursing Administration

Christine A. Donnelly, EDL, MSN, MA, RN

Determining Required Nursing Personnel
1. FTE Calculation

A full-time employee works 5 days a week or 40 hours per week for 52 weeks a year. This
amounts to 2,080 hours of work time. The formula is:

Total Nursing care hours X days in a year

Total annual hours per one FTE

2. HPPD Calculation

The formula is:

Total hours worked by nursing staff in a 24-hour period
The patient census at the end of that 24-hour period

Reference: Nursing Management, 2018, Volume 49 Number 5 , p 24 - 31

3. Determine average daily need

The formula is:

24H need = (Mode midnight census) x (budgeted HPPD)

Example:
= 30 (census) *6 (HPPD)
= 180 hours per 24-hour period needed

4. Calculate Productive Hours

The formula is:

24H Need
Productive Hours per Shift
Example:
= 180 hours (24H need) / 8 Productive Hours
= 22.5 (8-hour shifts)
5. Allocate FTE to Shifts and Skill Mix

In order to meet the needs of the patient population, the nurse leader has
determined that the unit requires:
33% AM Shift 33% PM Shift 33% Night Shift
The patients can be best cared for by a skill mix of:
70% RNs 20% UAP 10% NAS

The formula is:

Productive Hours * Percentage Needed per Shift
% Manager RNs (70%) UAP (20%) NAS (10%)
AM 0.33 0.5 4.96 1.42 0.71
PM 0.33 0.5 4.96 1.42 0.71
Night 0.33 4.96 1.42 0.71
Total 1 14.9 4.27 2.13
6. Consider the number of days to staff per week

Compute for the number of FTEs the nurse leader needs on each shift and in
each skill mix to cover the mode census. 7 days a week and 24 hours a day:

The formula is:

FTEs * Hours Worked per Day * Days to Staff
40 hours per Week

= 22.5*8 hours*7 days / 40 hours per week

=31.5

% Manager RNs (70%) UAP (20%) NAS (10%)

AM 0.33 0.5 7.04 2.01 1
PM 0.33 0.5 7.04 2.01 1
Night 0.33 7.04 2.01 1
Total 1 21.12 6.03 3
7. Account for productive and nonproductive time

This planning means that the staff members who are left behind working
aren't overworked to compensate for the employees who are on vacation.
This results in staff satisfaction.

The formula for the hours per FTE lost
to nonproductive time:
Total Number of Nonproductive Hours
Number of Clinical FTEs Who Are Replaced
If They Aren't At Work
The formula of the impact that this
nonproductive time has on the staffing
demand:
Average Number of Nonproductive Hours
per FTE
2080 Hours
(number of hours one FTE would work in 1 year without
taking any time off

Example: Example:
= 13480 (nonproductive hours) / 48.9 FTEs = 282 hours / 2080
= 282 hours =14% nonproductive time

MMC declared non productive time =16.2%

8. Add percentage of nonproductive time

Add percentage of nonproductive time to adjust for the Paid Time Off (PTO)
hours to take a vacation

% Manager RNs (70%) UAP (20%) NAS (10%)

AM 0.33 0.5 8.06 2.3 1.15
PM 0.33 0.5 8.06 2.3 1.15
Night 0.33 8.06 2.3 1.15
Total 1 24.17 6.9 3.45

Total FTE = 35.9

Our example unit started with a mode census of 30 patients and a budgeted
HPPD of 6. To staff this unit 24 hours per day, 7 days per week and account
for nonproductive time, the nurse leader needs 54.85 FTEs on the staffing
roster.
Thank you