Staffing
What is Flexible Staffing?
Flexible staffing plan is more difficult to develop. To be successful, these plans must be created with input from direct care staff.
What is Budget-Based Staffing?
The number of nursing hours per patient day or nursing hours is divided by the total patient days and then evaluated based on national benchmarks.
The number of adverse events such as falls and pressure ulcers on your unit is increasing. An ideal staffing plan to address this issue would include which of the following? Increasing the:
a. Total number of staff on the unit.
b. Staff and RN hours per patient.
c. Total number of staff, and implementing 12-hour shifts.
d. Number of RNs and number of RNs with experience on the unit
NS: D
A number of studies have identified that adverse events such as falls and pressure ulcers can be reduced by increasing the number of RNs on a unit (relative to other personnel) and utilizing experienced RNs. Overtime and 12-hour shifts are linked to a greater incidence of errors.
Her former manager demonstrated passion for serving her staff rather than being served. She takes time to listen, prefers to be a teacher first before being a leader, which is characteristic of:
A. Transformational leader
B. Transactional leader
C. Servant leader
D. Charismatic leader
C. Servant Leader
What are the three models for nursing staffing?
Patient Acuity
Budget-Based Staffing
A Nurse-Patient Ratio
What is Fixed Staffing?
Fixed set of nurses for a particular unit or shift. The results are an unalterable nurse-to-patient staffing ratio
A nurse on the unit is heard saying, "I am not going to document that I used four catheters to start that IV; it doesn't matter anyway." What action can help the staff nurse understand the financial budget goals of the unit?
a. Have the nurse work in payroll for a week.
b. Enroll the staff in continuing education units (CEU) for personal finance
c. Ask the nurse to represent the unit on the budget planning committee.
d. Make the nurse responsible for monitoring all disposable equipment and supplies
c. Ask the nurse to represent the unit on the budget planning committee.
To project staffing needs and to avoid understaffing, it is important that nurse managers consider which of the following?
a. Maximum productive hours
b. Average nonproductive hours
c. Minimum benefit hours
d. Maximum vacation time
ANS: B
To avoid understaffing, average nonproductive or benefit hours need to be taken into account, so the unit is properly staffed when staff members are off.
One leadership theory states that “leaders are born and not made,” which refers to which of the following theories?
A. Trait
B. Charismatic
C. Great Man
D. Situational
C. Great Man
How can being short-staffed affect patient outcomes? *Name one*
Mortality
Adverse Drug Events
Patient Satisfaction
Nurse Quality Outcomes
4 Key Points of Staffing
Patient need
RN nurse experience
Practice environment: ranging from supervisory support to continuing education
Staffing guidelines
A nursing unit's census consists primarily of long-term residents with a high risk for falls. To meet new safety regulations, the nurse manager must plan to replace all 50 patient beds with new beds equipped with Fall Watch electronic sensors that will detect when patients get out of bed. The manager will be involved in which type of budgeting to replace the beds?
a. fiscal
b. labor
c. operational
d. capital
4. capital
A nurse manager uses many sources of data when planning the unit's workload for the year. Which of the following data must be considered in the planning?
a. Hours of operation of the unit
b. Trends in acuity on the unit
c. Maximum work stretch for each employee
d. Weekend requirements
ANS: B
Acuity levels are determined through classification systems, which determine the nursing resources required.
Which of the following is true about functional nursing?
A. Concentrates on tasks and activities.
What is the difference between supplemental staffing vs float pools?
Supplemental staff works for agencies
Float Pools utilize pulled nurses from other units to staff where necessary
To prepare staffing schedules, a nurse manager needs to calculate paid nonproductive time. When calculating paid nonproductive time, the nurse manager considers:
a. Work time, educational time, and holiday time.
b. Paid hours minus worked hours.
c. Vacation time, holiday time, and sick time.
d. Paid hours minus meeting time.
ANS: C
Nonproductive hours are hours of benefit time and include vacation, holiday, and personal or sick time.
An important aspect of managing the costs on a unit is to plan accurately for staffing needs. Nurse managers use staffing plans to:
a. Assign staff on the unit on a daily basis.
b. Ensure that days off are planned for the staff.
c. Outline the number of individuals by classification on a per-shift basis.
d. Predict the numbers and classifications of float staff needed to augment regular staff.
ANS: C
A nurse manager needs to manage financial resources by developing staffing plans. Staffing plans plan for minimum number of professional nurses required on a unit at a given time or to the amount of minimum staffing in an extended-care facility or prison, based on regulatory guidelines.
The difference between staffing and scheduling is that staffing:
a. Puts the right person in the right position.
b. Puts the right person in the right time and place.
c. Refers to the number of nursing hours per patient per day.
d. Looks after interpretation of benefits and compensation.
ANS: A
Nursing staffing involves planning for hiring and deploying qualified human resources to meet the needs of a group of patients. Scheduling, on the other hand, is a function of implementing the staffing plan by assigning unit personnel to work specific hours and days of the week.
Beth orients her staff on the patterns of reporting relationships throughout the organization. Which of the following principles refer to this?
B. Hierarchy
Name three things that determine patient acuity?
The severity of presenting condition
Comorbidities
Age
Treatment needs
Patient's ability to care for their self
ANA Principles of Nurse Staffing
a match of registered nursing expertise with the needs of the patients in the context of the practice setting and situation.
Name three variables that can affect staffing schedules?
Hours of operation
Shift rotations
Weekend rotations
Approved benefit time for the schedule period—for example, vacations and holidays
Approved leaves of absence/short-term disability Approved seminar, orientation, and continuing education time
Scheduled meetings for the schedule period
Current filled positions and current staffing vacancies
Number of part-time employees
In reviewing the job description of a nurse manager, the staff becomes aware that a nurse manager's role is complex. Which of the following duties are required of a nurse manager? (Select all that apply.)
a. Ensure unit productivity reports.
b. Develop policy and legislation to protect nurses' well-being.
c. Plan staffing of UNPs only.
d. Prepare a unit budget that reflects unit staffing needs.
e. Monitor nurse-sensitive indicators such as falls and incidence of infections.
ANS: A, D, E
A nurse manager manages financial resources by developing business and staffing plans.
Stephanie is a new Staff Educator of a private tertiary hospital. She conducts orientation among new staff nurses in her department. Joseph, one of the new staff nurses, wants to understand the channel of communication, a span of control, and lines of communication. Which of the following will provide this information?
A. Organizational structure