* Spa Team at Mary

Immaculate
Hospital

Katherine Sheppard
NUR 4240

*Objective
* Mary Immaculate had a designated spa team which consisted of nursing
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assistants who would float to each department and provide care to patients.
This included:
A soothing bath experience.
Calming music.
Full head to toe bath with complete privacy from outside interruptions.
Patient satisfaction in the hospital was increased with the attention brought
forth by the spa team.
No additional education would be required because of the already hired
nursing assistants ability to perform tasks.

Services Offered:

Healing Touch
Complete care
Spiritual music therapy

The hospital contains four inpatient units.

In this proposal we will demonstrate the budget for the
Medical Surgical unit: 29 beds.

Mary Immaculate
Hospital

* Patient Satisfaction/HCHAPS Scores (Drives

reimbursement from Medicare and Anthem)

* Hemodynamics
* Pain Scores/ Skin Assessments
* Healing
* Developmental training for Certified Nursing Assistants
(CNAs)

*Driving Forces

*Time restraints required for each patient experience

*The spa team would consist of nursing assistants taking
from the allotted staff required for each department.
*Amount of time and training for each staff member to be
trained
*Labor cost of each employee
According to the U.S. Department of Labor the average
Cost for CNAs is $ 13.67 and the average cost for RNs is
$33.56 (U.S. Department of Labor, 2014).

*Restraining Forces

The first alternative would be to continue care as is with no spa team.

* CNA: Patient Ratio will remain on the units.
* Current Certified Nursing Assistant (CNA): patient ratio is 1:15.
* Nurse to patient ratio: 1: 4-6

Advantages:
- No increase in budget
- No special training needed.

Disadvantages:
-Spa team will not be in effect for those who are interested in receiving this care.
- Loose out the opportunity to increase driving forces by implementing the SPA team.
- CNAs will have more critical duties and less time to spend 1:1 time with each patient

*Alternative One

*Budget for

Alternative One
No addition budget change
No Material Costs
Utilizing the current staffing ratios mention previously (Nurse: Patient 1:4-5
and CNA 1:15)
Medical Surgical : 29 patients, 5 nurses, and 2 CNAs
Using the average cost based on U.S. Department of Labor
29 patients (Incoming Money)
5 Nurses ( 5 x $33.56) $167.8/ hour
2 CNAs (2 x $13.67) $27.34/hour
Total out per hour $195.14 for the Medical Surgical Unit

* Designate two additional nursing assistants to the spa team to round on patients for healing
touch and two nursing assistants for complete care patients.

-Allow an allotment of 30 minutes per patient to perform healing touch, message, and healing music.
-Allow an allotment of 45 minutes per patient to perform complete care baths.

* Advantages:
In a 12 hour shift about 18-20 patients will be seen considering an average of 37 minute increments
providing care as stated above- that is 18-20 more patients with the experience of healing touch than none.
Specified staff members would round on patients would be more familiar with the tasks in order to get done
quicker.
Increase driving forces
Increase patient satisfaction
Disadvantages:
Staff members are pulled from the CNA staffing to perform more critical duties
Education would be needed to train staff on how to perform duties in a timely manner.
Additional funds to the budget (more money)

*Alternative Two

Staffing algorithm for Mary Immaculate medical surgical unit Day

Shift
Number of staff members multiplied (X) 8 hour shift divided by
total number of patients on each unit (D. Beasley, personal
communication, September 21,2015).
Scenario Example for Alternative two:
5 nurses
2 CNAs
2 spa team members
Medical Surgical: 9 staff members x 8 hours/ 29 patients = 2.48
which is under the estimated budget set at 3.66 hours per
patient.
Option: Replicate algorithm for other units to utilize 2 staff
members to represent the spa team on each unit.

*Budget for

Alternative Two
Adding two staff members to the budget
No additional materials needed
Utilizing the current staffing ratios mention previously (Nurse: Patient 1:4-5
and CNA 1:15)
Medical Surgical : 29 patients, 5 nurses, and 2 CNAs
Using the average cost based on U.S. Department of Labor
29 patients (Incoming Money)
5 Nurses ( 5 x $33.56) $167.8/ hour
2 CNAs (2 x $13.67) $27.34/hour
2 CNAs to represent Spa Team (2 x 13.67) $27.34/hour
Total out per hour $222.48 for the Medical Surgical Unit

Offer classes to train in SPA services in order to rotate staff

when needed.
Advantages:
Cross training staff will be beneficial in the event of absenteeism.
Disadvantages:
Cost analysis for amount of time spent in class for each
employee.
More evaluation of staff members trained for efficiency would be
needed.

*Alternative Three

*Budget for

Alternative Three
Utilizing the current staff with approximately 2-3 Certified Nursing Assistants
(CNAs) per unit on a given shift.
Using the average cost based on U.S. Department of Labor
2 CNAs (2 x $13.67) $27.34/hour
If these two CNAs were to attend a four hour class on how to
perform duties of a Spa Member this would cost approximately $109.36.

Alternatives at a glance
How the Hospital Budges
- Hourly rate
- Number of hours each year (2,080 hours)
- Full time equivalent for 2 CNA staff (8.4 in a 24 hour
period)
- Option 1: No changes in the budget
- Option 2: Additional $238.000 per year to add two
staff members.
- Option 3: Utilize staff and costs for class would be
$109.36 for every 2 CNAs to attend

Recommendation:
Start with alternative two. This would help add
two staff members to the team and make a
trial run for each unit.
CNAs would benefit by less workload and
increase patient satisfaction.

References

United States Department of Labor. (2014). Occupational

employment and wages, May 2014. Retrieved from Bureau of
Labor Statistics:
http://www.bls.gov/oes/current/oes311014.htm

Bon Secours Administration. (2015). Newport News, Virginia .