BURAIDAH C ENTRAL H OSPITAL

Department : NURSING SERVICE Policy Index : PP-BCH-NR/GNR-004-DPP-E Title : NURSING SERVICES STAFFING PLAN AND RATIOS Effective Date : Applies to : 01-01-1432 H All Nursing Staff New

B. C. H.

DPP

Replace Number : XXXXX Number of Pages : 5 Review Due : 01-12-1433 H

1. PURPOSE: 1.1 To facilitate the provision of accurate Nurse/Patient staffing ratios based on each specific units required hours/patient which has been determined by assessment of patients acuity. Staff Related : ( Purpose ) 1.1.1 The specific needs of various patients determine the appropriate clinical competencies required of the Nurse working in that area : 1.1.1.1 Experienced Registered Nurse should give clinical support to those with less experience. 1.1.1.2. Registered Nurse must have nursing management support and represen tation both at the operational and administrative level. Patient Care Related : 1.1.2 This is to create an appropriate staffing level for a patients care reflecting the analy sis of individual and total patients need. 1.1.2.1 Unit functions necessarily to support delivery of quality patient care depends on staffing level. Institutional / Organization Related : 1.1.3. The Organizational Policies should recognize the complex needs both of patients and nursing staff. Recommendation :
Prepared by: Magdalena Venzuela Nurse Supervisor

1.1.4 It is favorably advice that nurses competence is needed to provide quality patient Approval
Approved by: Ahmad Abdulla Al-Omar Hospital Director Page Number: 1/5 Stamp

Form Index: BCH-QM-009-E

care, thus a distinct standardized method of unit intensity is improved.

The folllowing Nurse Qualities should be taken into account : 1 Level of experience. 2 Education, including Certification. 3 Length of stay in the Unit. 4.The degree of involvement in activities such as Nursing Research which add to nursing knowledge. 5.Involvement in interdisciplinary and collaborative activities regarding patient needs. 6.The number of competencies of clinical and non-clinical support the Registered Nurse jointly and Supervisor.

2. DEFINITION :
2.1 Staffing Plan - is a written plan that established the specific number of Registered Nurse required to be present for each shift to ensure safe patient care. 3. POLICY: 3.1 It is the Hospital Policy that Nurse Staffing shall be based on specific needs of patients, the nursing staff experience and the support services availability. 3.2 A Registered Nurse must be in charge every 8 hours shift. 3.3 The Registered Nurse plans, organize and performs all care. 3.4 Total Staffing is calculated based on five patients to one nurse in the General wards and in Critical area like ICU, one patient to one nurse ( if ventilated ) and one nurse to two patients if non-ventilated. 3.5 Staffing needs / Procedure will be determined by the In-Charge Nurse or Team Leader based on allocation, complexity of case and skill level of the nurse. 3.6 The Head Nurse makes the assignments in advance and can ask for additional if needed. 3.7 Cross training of personnel, floating and pull out alignment staffing and optimizes re sources. 4. PROCEDURES : 4.1 The Staffing Ratio For General Ward Is Calculated as Below : Legend : 4 = Represents the Nursing Hours. 1.16 = (Constant) representing 7 Days / Week or 6 days / week ( FTW) 1.14 = Full Time Equivalent (FTE) for vacation, illness. 8 = Represents Work Day. 27 = Average Daily Census. FTE = Full time Employee. FTW = Full time Worker. WTE = Work Time Equivalent. Average Daily Census
Policy Number: PP-BCH-NR/GNR-004-DPP-E

Title NURSING SERVICES STAFFING PLAN AND RATIOS

4 8

1.16

1.4 = Required Number of Staffing.

Page Number: 2/5 Approval Stamp

Form Index: BCH-QM-009-E

1. Male Medical Ward :

27 x 4 x 1.16 x 1.14 = 8 142.81 = 17.8524 = 18 = Total Nurses Needed. 8

2. Female Medical Ward : 25 x 4 x 1.16 x 1.14 =

8
3. Male Surgical Ward : 28 x 4 x 1.16 x 1.14 = 8 4. Female Surgical Ward : 20 x 4 x 1.16 x 1.14 = 8 5. Male Orthopedic Ward : 12 x 4 x 1.16 x 1.14 = 8

132.24 8

= 16.53 = 16 = Total Nurses Needed.

148.10 8

18

18.51 = Total Nurses Needed.

105.79 8

= 13.24

= 13 = Total Nurses Needed.

63.47 8

7.93

= 8 = Total Nurses Needed.

6. Female Orthopedic Ward : 6 x 4 x 1.16 x 1.14 = 8 31.73 8 = 3.96 = 4 = Total Nurses Needed.

7. T. B. W :
12 x 4 x 1.16 x 1.14 = 8 63.47 8 = 7.93 = 8 = Total Nurses Needed.

Emergency Department , AKU and OPD : Staffing Ratio is Calculated with this Formula : No. of Beds x Nursing Hours Worked / Day x 1.16 x 1.14 . 8 ( working Hours / Day )

1. Emergency Department :
35 x 8 x 1.16 x 1.14 = 8
Policy Number: PP-BCH-NR/GNR-004-DPP-E

46.284 = 46.284 = 46 = Total Nurses needed in ER. 8

Page Number: 3/5 Approval Stamp

Title NURSING SERVICES STAFFING PLAN AND RATIOS

Form Index: BCH-QM-009-E

2. Artificial Kidney Unit : 20 x 8 x 1.16 x 1.14 = 8 26.4480 = 27 = Total Nurses needed in AKU. 8

3. Out Patient Department :

22 x 8 x 1.16 x 1.14 = 8 29.0928 = 29 = Total Nurses needed in OPD.

Formula to determine Full time Employees Required for Critical Area :

4. Intensive Care Unit :

No. of Nurses x Working Hrs. / Day x 7 Days ( 1 week ) Working Hours / Week 24 x 8 hrs. x 7 days = 28 Work Time Equivalent. 48 hrs. ( 1 week ) = 28 + 23 % WTE. = 34.4 = 34 = Total Nurses needed in ICU.

5. Operating Theatre :
Total patient / Year divided by 365 = 3000 365 = 8.21 ( average daily census ) x 8 hrs./ patient day ). = 65.75 ( hours of direct patient care required / day . Hours of direct patient care / day x 30 days / pay period . = 65.75 x 30 = 1972 .6 hrs. ( care required / pay period.) FTE Care Givers Required = Hours of care required / pay period / 85 hours ( constant no.) = 1972 .6 85 = 23.20 nurses. = 23 nurses. 4.2 Staffing for the Whole Hospital : BCH is a Secondary Hospital with 212 bed capacity that provides health care for Inpa tient and Outpatient. The Hospital also received referral cases from nearby Primary and Secondary Health Institution. Currently, the total manpower of the Nursing Department is 253 and the distribution of manpower is shown in the total breakdown statistical report. 4.3 HPPD ( Hours per patient Per Day / Acuity.) This is a method by which the number of staff needed for total direct productive hours of care per patient per day ( HPPD ) for the number of patient expected to require nursing care over a given period of time.
Policy Number: PP-BCH-NR/GNR-004-DPP-E Title NURSING SERVICES STAFFING PLAN AND RATIOS Page Number: 4/5 Approval Stamp

Form Index: BCH-QM-009-E

4.4 Calculating HPPD takes into account : 4.4.1 The number of minutes and hours Nursing staff directly interact with the patients.

4.4.2 The time it takes to administer treatment, medications, monitor patients and provide teaching. 4.4.3 It reflects the time staff takes to document care, order supplies. Prepare medications and direct other caregivers. 4.4.4 HPPD is the sum of all direct care, time provided by all staff members who care for a patient within 24 hours. 4.4.5 If patient acuity is so high extra nurses are called in, to provide care or pull outs are given.

5. FORMS AND EQUIPMENTS :

5.1 Average Daily Census Form. 5.2 Staffing Ratio Form.

6. REFERENCES :
6.1 www. Ask/com. 6.2 Ministry of Health Policy and Procedures Manual.

7. APPENDIX :
6.1 N/A. 8. APPROVAL:

Name Prepared by: Magdalena Venzuela 1. Abdulla Obeid Al-Harby Reviewed by: 2.Ehab El Husseiny Ibrahim 3.Manae Al-Belaihy Approved by: Ahmad Abdulla Al-Omar

Position Nurse Supervisor Nursing Director QM Director Medical Director Hospital Director

Signature

Date
22-11-1431 H 24-11-1431 H 29-11-1431 H 29-11-1431 H 01-12-1431 H

Policy Number: PP-BCH-NR/GNR-004-DPP-E

Title NURSING SERVICES STAFFING PLAN AND RATIOS

Page Number: 5/5

Approval Stamp

Form Index: BCH-QM-009-E

Policy Number: PP-BCH-NR/GNR-004-DPP-E

Title NURSING SERVICES STAFFING PLAN AND RATIOS

Page Number: 6/5

Approval Stamp

Form Index: BCH-QM-009-E