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Staffing is the process of determining and providing the acceptable number and mix of nursing personnel to produce a desired level of care to meet the patients demand

The purpose of all staffing activities is to provide each nursing unit with an appropriate and acceptable number of workers in each category to perform the nursing tasks required.
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1. the type, philosophy, objectives of the hospital and the nursing service. 2. the population served or kind of patients served whether pay or charity. 3. the number of patients and severity of their illnessknowledge and ability of nursing personnel are matched with the actual care needs of patients 4. availability and characteristics of the nursing staff, including education, level of preparation, mix of personnel, number and position.

5. administrative policies such as rotation, weekends, and holiday off duties. 6. standards of care desired which should be available and clearly spelled out. 7. layout of various nursing units and resources available within the department such as adequate equipment, supplies, and materials 8. budget including the amount allotted to salaries, fringe benefits, supplies, materials and equipment 9. professional activities and priorities in nonpatient activities likeinvolvement I professional organizations, formal educational development, participation in research and staff development.

10.teaching program or the extent of staff involvement in teaching activities. 11.expected hours of work per annum of each employee. This is influenced by 40 hour week law. 12.patterns of work schedule-traditional 5 days per week, 8 hours per day; 4 days a week, ten hours per day and three days off; or 3 days of 12hours per day and 3 days off per week.

Recruiting Recruitment is the process of actively seeking out or attracting applicants for existing positions. It should be an ongoing process in order to meet demand and provide adequate supply of nurses at any given time.

The nurse manager may be greatly or minimally involved in recruiting interviewing and selecting personnel depending on: (a) the size of the institution, (b) the existence of a separate personnel department, (c) The presence of a nurse recruiter within the organization, and (d) the use of centralized or decentralized nursing department.
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The patient care classification system is a method of grouping patients according to the amount and complexity of their nursing care requirements and the nursing time and skill they require. This assessment can serve in determining the amount of nursing care required, generally within 24 hours, as well as the category of nursing personnel who should provide that care.

1. The number of categories into which the patients should be divided; 2. The characteristics of patients in each category; 3. The type and number of care procedures that will be needed by a typical patient in each category; and 4. The time needed to perform these procedures that will be required by a typical patient in each category.

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Level I Self Care or Minimal Care Moderate Care or Intermediate Care Level III Total, Complete or Intensive Care Level IV Highly Specialized Critical Care

Levels of Care

NCH Needed Per Pt. Per Day 1.50

Ratio of Prof. to NonProf. 55:45

Level I Self Care or Minimal Care Level II Moderate or Intermediate Care Level III Total or Intensive Care Level IV Highly Specialized or

3.0

60:40

4.5

65:35

6.0 7 or higher

70:30 80:20

Cases/Patients 1. GeneralMedicine 2. Medical 3. Surgical 4. Obstetrics 5. Pediatrics 6. Pathologic Nursery 7. ER/ICU/RR 8. CCU

NCH/Pt/day 3.5 3.4 3.0 3.0 4.6 2.8 6.0 6.0

Prof. to Non Prof. Ratio 60:40 60:40 60:40 60:40 70:30 55:45 70:30 80:20

Type of Hospital Primary Hospital Secondary Hospital Tertiary Hospital 30 45 15 10 Spl. Tertiary Hospital

Minimal Care 70 65 Tertiary Hospital 30 10

Moderate Care 25 30 45

Intensive Care 5 5 15

Highly Spl. Care 10

25

45

20

Rights and Privileges Given Each Personnel Per Year 1. Vacation Leave 2. Sick Leave 3. Legal Holidays 4. Special holidays 5. Special Privileges 6. Off-Duties as per R.A. 5901 7. Continuing Education Program Total Non-Working Days Per Year Total Working Days Per Year Total Working Hours Per Year

Working Hours Per Week 40 Hours 15 15 10 2 3 104 3 152 213 1,704 48 Hours 15 15 10 2 3 52 3 100 265 2,120

To compute for relievers needed, the following should be considered: 1. Average number of leaves taken each year - - - - - - 15 a. Vacation Leave - - - - - - - - - -- - - - - - - - - - - - - 10 b. Sick Leave - - - - - - - - - - - - - -- - - - - - - - - - - - - 5 2. Holidays - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - 12 3. Special Privileges as per CSCMC#6 s.1996 - - - - - - -3 4. Continuing Education Program for Professionals - - 3 Total Average Leaves 33
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employee is entitled to 15 days sickleave and 15 days vacation leave,12holidays, 3 days for continuing education, plus 3 days of special privileges or 48 days total, he or she gets only an average of 33 days leave per year. To determine the relievers needed, divide 33 (the average number of working days an employee is absent per year) by the number of working days per year that each employee serves (whether213 or 265). This will be 0.15 per person who works 40 hours per week and 0.12 per person for those working 48 hours per week. Multiply the computed reliever per person by the computed number of nursing personnel. This will give the totalnumber of relievers needed.

Studies have shown that the morning or day shift needs the most number of nursing personnel at 45 to 51percent; for the afternoon shift 34 to 37percent; and for the night shift 15 to 18percent. In the Philippines the distribution usually followed is 45 percent for the morning shift, 37 percent for the afternoon shift, and 18 shift for the night shifts.

To compute for the staff needed in the In-Patient units of the hospital the following steps are considered: 1. Categorize the number of patients according to the levels of care needed. Multiply the total number of patients by the percentage of patients at each level of care (whether minimal, intermediate, intensive or highly specialized). 2. Find the total number of nursing care hours needed by the patients at each category level. a. Find the number of patients at each level by the average number of nursing care hours needed per day. b. Get the sum of the nursing care hours needed at the various levels.

3. Find the actual number of nursing care hours needed by the given number of patients. Multiply the total nursing care hours needed per day by the total number of days in a year. 4. Find the actual number of working hours rendered by each nursing personnel per year. Multiply the number of hours on duty per day by the actual working days per year. 5. Find the total number of nursing personnel needed. a. Divide the total number of nursing care needed per year by the actual number of working hours rendered by an employee per year. b. Find the number of relievers. Multiply the number of nursing personnel needed by 0.15 (for those working 40 hours per week) or by 0.12 (for those working 48 hours per week). c. Add the number of relievers to the number of nursing personnel needed.

6. Categorize the nursing personnel into professionals and non-professionals. Multiply the number of nursing personnel according to the ratio of professionals to non-professionals. 7. Distribute by shifts.

To illustrate: Find the number of nursing personnel needed for 500 patients in a tertiary hospital.
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1. Categorize the patients according to level of care needed.

500 (pts) x .30 = 150 patients needing minimal care 500 (pts) x .45 = 225 patients needing moderate care 500 (pts) x .15 = 75 patients need intensive care 500 (pts) x .10 = 50 patients need highly specialized nursing care 500

2. Find the number of nursing care hours (NCH) needed by patients at each level of care per day.
150 pts x 1.5 (NCH needed at Level I) = 225 NCH/day

225.5 pts x 3 (NCH needed at Level II) = 675.5 NCH/day 75 pts x 4.5 (NCH needed at Level III) = 337 NCH/day 50 pts x 6 (NCH needed at Level IV) = 300 NCH/day Total 1537.5
NCH/day

3. Find the total NCH needed by 500 patients per year. 1537.5 x 365 (days/year) = 561,187.50 NCH/year 4. Find the actual working hours rendered by each nursing personnel per year. 8 (hrs/day) x 213 (working days/year) = 1,704 (working hours/year) 5. Find the total number of nursing personnel needed. a. Total NCH per year = 561,187.50 = 329 Working hrs/year 1,704

b. Relief x Total Nursing Personnel = 329 x 0.15 = 49 c. Total Nursing Personnel needed 329 + 49 = 378 6. Categorize to professional and non-professional personnel. Ratio of professionals to nonprofessionals in a tertiary hospital is 65:35. ` 378 x .65 = 246 professional nurses ` 378 x .35 = 132 nursing attendants

7. Distribute by shifts. ` 246 nurses x .45 = 111 ` 246 nurses x .37 = 91 ` 246 nurses x .18 = 44 ` Total 246
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nurses on AM shift nurses on PM shift nurses on night shift nurse

132 Nursing attendants x .45 = 59 Nursing attendants on AM shift 132 Nursing attendants x .37 = 49 Nursing attendants on PM shift 132 Nursing attendants x .18 = 24 Nursing attendants on night shift Total 132 Nursing Attendants