STAFFING

⮚ Is the process of determining and assigning the right

personnel to the right job.

⮚ It is the largest and the most crucial aspect of

administration because the quality of the personnel and
their performance will determine the degree of achieving
the goals of the Nursing Service.
Factors And Steps in
Determining Staffing Needs:
1. Factors to be considered in determining nursing care
hour/patient in 24 hours.

1.1 Patients Acuity of Illness

a. Level of Care
- Obstetric – Gynecology
- Pediatrics
- Medical
- Surgical
 b. Degree of Dependence
c. Communicability
d. Rehabilitation Needs

1.2 Special treatment and procedures

1.3 Type of Hospital
1.4 Ratio of Professional to non professional nursing personnel.
1.5 Turnover of patients and nursing personnel
1.6 hospital policy
1.7 Budget
1.8 Available equipment/materials/supplies
1.9 Population served
2. Steps for computing the Nursing Care Hours (NCH)

Formula:
No. of Nursing = Average occ. Rate X NCH
Personnel No. of Working Hours
Cases/Patients NCH Prof: Non Prof Ratio
General Medicine 3.5 60:40
Medical 3.4 60:40
Surgical 3.4 60:40
Obstetrics 3 60:40
Pediatrics 4.6 70:30
Pathologic
Nursery 2.8 55:45
ER/ICU/RR 1:2-3 patients 80:20
CCU 1:1-2 patients 80:20
Patient Classification System
• Patient classification allows a more accurate computation of
nursing needed for different categories of patients. It is a
method used for grouping patients according to the amount
and complexity of their nursing care requirements over a given
period of time.
 Levels of Care Number of Nursing Care
Hours Needed Per Patients
Per Day

Level I - Minimal Care 1.5

Level II - Intermediate 3.0
Care 4.5
Level III - Intensive Care/
Total care 6.0
Level IV - Highly
Specialized
Critical Care

Number of Nursing Care Hours Needed Per

Patient Per Day Per Levels of Care
Levels of Care:
Level I – Self-care or nominal care category. Under this category
the patient is capable of carrying out daily activities as long as
the nurse provides he necessary materials and supplies.
Level II – Intermediate or moderate or partial care category.
Level III – Total Care/Intensive Care Category.
Level IV – Critical Care- An acute or critically-ill patient who is in
constant danger of death or serious injury would require
critical care.
 Levels of Care Ratio of Professional
Nurses to Non-
Professionals/Nursing
Personnel
Level I – Minimal Care Patients 55-45

Level II – Intermediate or 60-40

Moderate Care Patients

Level III – Total Care Patients 65-35

Level IV – Highly Specialized 70-30 or

Care 80-20
Patients

The Ratio of Professional Nurses to Non-Professional Nursing

Personnel in Various Levels of Care
TYPE OF HOSPITAL PERCENTAGE OF PATIENTS IN VARIOUS
LEVELS OF CARE

Minimal Moderate Intensive Highly

Care Care Care Specializ
ed
Care

Primary Hospitals 70 25 5
65 30 5
Secondary Hospitals 30-40 50-60 15-25 5-10
Tertiary Hospitals 20-30 50-60
10-20 20-30
Special Tertiary
Hospital

Percentage of Patients in Various Levels of Care Per

Type of
Hospital
 Determining the Number of Nursing
Personnel
Needed
⮚ The number of nursing personnel to staff the various
units/departments should be sufficient to cover the service
even when part of the personnel are off-duty, absent, or off on
legal holidays.
⮚ The number of working hours and off-duties in this country is
largely dependent on the Forty-Hour-Per-Week Law otherwise
known as R.A 5901.
The following policies as regards to work leaves are
assumed to be given regardless of the number of working
hours per week

1. 15 days each per year for

vacation and sick leaves
2. 10 legal holidays per year
3. 2 special holidays per year
4. 3 days of continuing
professional education per year,
for a total of 45 days per year.
 Total Number of Working Days, Non-Working Days and Hours
of
Nursing Personnel per Year

Rights and Privileges Given Working Hours Per Week

Each Personnel
40 hrs. 48 hrs.
1. Days of Vacation Leave 15 15
2. Days of Sick Leave 15 15
3. Legal Holidays 10 10
4. Special Holidays 2 2
5. Continuing Education 3 3
6. Off Duties R.A 5901 104 52

Total nonworking days/year 149 97

Total working days/years 216 268
Total working hours/year 1,728 2,144
Relievers Needed
Each employee is entitled to 10 days vacation leave and
5 days sick leave every year. They are also entitled to 12 days off
during holidays and 3 days off to attend continuing education
programs. Since the total average of absences is 35 days a year,
(35/365), the actual relief needed for each is .095.

Distribution by Shifts
Studies have shown that more nursing care are given
during the morning and afternoon shifts. The morning shifts
requires the most number of nursing personnel at 45%, the
afternoon shifts requires about 37% and the night shifts only
about 18%.
Formula for Computing the Number of Staff Needed in
the In-Patient Areas of the Hospital

1. Categorize the number of patients X percent at each levels of

care needed by hospital classification.
a. Total number of patients X percent at each level of
care (whether minimal, intermediate, intensive or highly-
specialized intensive area)

2. Find the total number of nursing hours needed by patients per

year at each categorized level.
a. Number of patients at each level X average nursing
hours needed per day.
b. Get the sum of the nursing hours in the various levels.
3. Find the actual total number of working hours needed by
these patients per year.
a. Total number of nursing hours needed per day X
365 (total number of days in a year)

4. Find the actual total number of working hours rendered

by each nursing personnel each year.
a. Hours on duty per day X actual working days per
year.

5. Find the total nursing personnel needed.

a. Divide the total number of nursing hours needed
by the given number of patients per year by the actual
number og working hours rendered per day.
 b. Find the relief. Multiply the number of personnel
needed by .095.
c. Add the number of relievers to the number of
nursing personnel needed.

6. Categorize into professional and non professionals.

a. Multiply the number of nursing personnel
according to the ratio of professional to non professional
personnel.

7. Distribute by shifts.
To Illustrate:
Find the number of nursing personnel needed for
100 patients in a tertiary hospital.

Step 1: Categorize patient according to levels of care.

100(pts.) X .60 = 65 pts. needing minimal care
100(pts.) X .30 = 30 pts. Needing moderate/
intermediate care
100(pts.) X .05 = 5 patients needing intensive care
100(pts.) X 0.1 = 10 patients needing highly
specialized care
Step 2: Find the number of nursing care hours (NCH) needed by
the patient per day at each categorized level.

65 X 1.5( Nsg. care hrs needed = 97.5 nsg. care hrs. needed by
per day at level 1) 65 patients

30 X 3 (Nsg. care hrs. needed

per day at level 2) = 90 nsg. care hrs needed by 30
patients
5 X 4.5 (Nsg. care hrs needed
per day) =22.5 nsg. Care hrs. needed by
5 patients

Total = 210 Nursing Care Hours/day

Step 3: Find the actual number of NCH needed by 100
patients per year.
210 X 365 = 76,650 total NCH needed per year.

Step 4: Find the number of nursing personnel needed.

a. 76,650 (NCH/year)
1728(working hrs./year) = 44 Nursing Personnel

b. 44 X .095 = 4.18 or 4 Nursing personnel as

Relief

c. 44 + 4 = 48 Total Nursing Personnel Needed

Step 5: Categorize according to professional and non
professional personnel.
44 X .60 = 26.4 Nurses
44 X .40 = 17.6 Nursing Attendants

Step 6: Distribute by Shifts

26 X .45 = 12 Nurses on 7-3 17 X .45 = 8 Nsg. Attendants 7-3

26 X .37 = 10 Nurses on 3-11 17 X .37= 6 nsg. Attendants 3-11

26 X .18 = 4 nurses on 11-7 17 X .18= 3 nsg. Attendants 11-7

Total = 26 Total = 17
REFERENCES:

⮚ Drucker, Peter F. Management: Task, Responsibilities,

Practices. New York: Harper and Row Publisher, Inc.,1984
⮚ Ganong and Ganong. Nursing Management, 2nd edition aspen
publication. 1989
⮚ Gillies, D.A. Nursing Management: A System Approach.
Philadelphia: W.B. Saunders Co., 1982
⮚ Philippine Nurses Association. Standards Of Nursing Practice.
Vol.1, revised 1987