Get Answer: Part Calculating Full Question Guide

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Original Question

Part I: Calculating RN Full Time Equivalents (FTEs) As the manager, you have been asked to provide an RN staffing plan for a 40-bed in-patient nursing unit with an Average Daily Census of 40. The proposed staffing ratio is 1:6 (1 nurse for each 6 patients per shift). Using the Nursing Hours Per Patient Day (NHPPD) methodology, calculate the number of FTEs needed to staff the unit for a 14-day pay period. Use the information in the Welch and Smith (2020) article to assist with your analysis. Convert Nurse Patient Ratio to NHPPD. Ratio 1:6 24 hours/day 24/6 = 4 NHPPD (Welch & Smith, 2020) Determine the nursing unit annual volume in patient days. Average daily census at midnight= 40 365 days in a year/12 month period 40 x 365 = $14,600 (Welch & Smith, 2020) Determine total NHPPD for the previous year. 4 NHPPD for the unit $ 14,600 annual volume in patient days 4 x 14,600 = 58,400 NHPPD for prior year ( Welch & Smith, 2020) Determine number of FTEs needed to staff the unit. 58,000 NHPPD 2080 total hours annually for 1.0 employee 58,000/2080 = 28.0 FTE to staff the unit (Welch & Smith, 2020) Explain why the unit uses a particular staffing ratio and how that ratio is determined. Staffing units use particular evidence-based staffing ratios to achieve both clinical and financial outcomes for their units. Using patient classification systems and management tools help to determine the acuity of the patients which can increase or decrease the nursing workload. Ratios can be determined by patient acuity, average daily census or unit of service, and nursing/patient workload (Welch & Smith, 2020). Explain whether other units in the same facility would have the same staffing ratio or different staffing ratios. Justify your response. Units in this facility may have different ratios. Such factors such as critical care departments including PICU, NICU, Cardiac ICU change the ratios based on acuity. Patients on cardiac monitors may have a ratio of 1: 4 such as the mandatory ratio in California or 1 :2 in the ICU. Daily discharges admissions which can require more education and assessment can change the ratio on a unit. Higher workload for certain patients can change the ratio thus needing more staff. One study in Israel using 168 hospitals found that increasing the ratio from 1 :4 to 1 : 6 raised the mortality by 7% (Sharma & Rani, 2020) Changes in patient status and how dependent the patient needs are while admitted can also change the acuity of the unit. The American Nurses Association strongly believes that nursing ratios should be based on patient acuity, stability, availability of ancillary support such as techs or other sources, nurse skill level, number of patients coming in and out and layout of the unit (American Nurses Association, 2022). As the front-line staff patient outcomes can be affected by any of the above. Staffing ratios can not be rigid but a fluid assessment based on the daily needs of the unit. Part II: Calculating Salary Costs Based on the FTEs you calculated in Part I, calculate the salary cost for each nurse FTE using the hourly wage multiplied by 2,080 (number of hours worked per year), then add 30% to cover benefits. Use the following to make your calculations: RN salary: $32.50 per hour + 30% for benefits = $42.25 per hour. Determine the salary per year for one RN FTE. $ 42.24 per hour 2080 hours worked per year 42.24 x 2,080 = $87,800 per year Calculate the total salary costs for the entire RN staff to determine your initial professional staff budget for the entire year. $87,800 per year for 1 staff 28 FTE staff 87,800 x 28 = $ 2,460,640 Explain the importance of budgeting when making staffing decisions. Part III: Creating a Staffing Chart for 4 North Day Shift Using the FTEs you have determined you need in Part 1, create a staffing plan for a 14 day pay period for the 4 North day shift. Remember that a nurse who works 36 hours per week (72 hours per pay period) is a 0.9 FTE; 24hrs/week (48 hours per pay period) is a 0.6 FTE; and 12hrs/week (24 hours per pay period) is a 0.3 FTE. Each pay period is 2 weeks, but overtime is accrued after 40 hours each week. Each week runs from Sunday through Saturday. No one can be scheduled in overtime either week. 4 North Schedule FTE Sun Mon Tues Wed Thu Fri Sat Sun Mon Tues Wed Thu Fri Sat Day Shift 7a-7p Example RN 0.9 X X X X X X K. Barnes RN H. Keller RN J. Jones RN A. Hills RN D. Scott RN S. Guyan RN J. Williams RN Z. David RN M. Williamson RN P. Webb RN D. Carey RN (Add or delete RNs as needed) Total FTEs/Staff scheduled ?

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