Staffing

 is
the process of determining and
providing the acceptable number
and mix of nursing personnel
(projected to the actual patient
care needs) to produce a desired
level of care to meet the
patients’ demand.
 toprovide each nursing unit with an
appropriate and acceptable number
of workers in each category to
perform the nursing tasks required

**Too few or an improper mixture of

nursing personnel  affect the
quality and quantity of work
performed absenteeism and staffs
turn-over
 the type, philosophy, and objectives of the
hospital and nursing services;

 the population served

 the number of patients and severity of their

illness

 availability and characteristics of the nursing

staff,

 administrativepolicies such as rotation,

weekends and holiday off-duties;
 Standards of care desired which should be available
and clearly spelled out.

 layout of the various nursing units and resources

available within the department such as adequate
equipment, supplies, and materials;

 budget including the amount allotted to salaries,

fringe benefits, supplies, materials, and equipment;

 professional activities and priorities in non patient

activities like

 Teaching program or the extend of staff involvement

in teaching activities;
 Expected hours of work per annum of each
employee. This is influenced by the 40-
hour week- law;

 patternsof work schedule-traditional 5 days

per week; 8 hours per day;
 TABLE1. Nursing care hours per patient per
day according to classification of
patients by units.
Cases/Patients NCH/PT/Day Prof. to Non
Prof. Ratio
General Medicine
Medical 3.5 60:40

Surgical 3.4 60:40

Obstetrics 3.4 60:40

Pediatrics 3.0 60:40

Pathologic 4.6. 70:30

Nursery 2.8 55:45

ER/ICU/RR 6.0 70:30

Patient Care Classification
System

isa method of grouping

patients according to the
amount and complexity of
their nursing care
requirements and the nursing
time and skill they require.
 the number of categories into which the patients
should be divided:

 the characteristics of patients in each category;

 the type and number of care procedures that

will be needed by a typical patient in each
category; and

 the time needed to perform these procedures

that will be required by a typical patient in each
category.
 various units may develop their own ways
of classifying patients care according
to the acuity of their patient’s
illnesses.

 Level I- Self Care or Minimal Care-

. can take a bath on his own,

.feed himself,
.feed and perform his activities
of daily living.
Level II – Moderate Care
or Intermediate Care –

 need some assistance

( bathing, feeding, or
ambulating for short
period of time)
**Extreme symptoms of their illness
must have subsided or have not yet
appeared.
Level III – Total, Complete or
Intensive Care
 completely dependent upon the nursing
personnel.
 They are provided complete bath, are fed,
may or may not be unconscious,
 with marked emotional needs,
 with vital signs more that three times per
shift,
 may be on continuous oxygen therapy, and
with chest or abdominal tubes.
Level IV- Highly Specialized
Critical Care

 need maximum nursing care

 with a ration of 80 professionals to 20

non- professionals.
 Table 2. Categories or levels of care of patients,
nursing care hours needed per patient per day and
ratio of professional to non-professionals.
Levels of Care NCH Needed Per Ratio of Prof. to Non-
PT. Per Day Prof.

Level I 1.50 5:45

Self Care or Minimal
Care

Level II 3.0 60:40

Moderate or
Intermediate Care

Level III
Total or Intensive 4.5 65:35
Care

Level IV 6.0 70:30

Highly Specialized or
Critical Care 7 or higher 80:20
  Table 3. Percentage of patients at various levels of care
per type of hospitals.

Type of Hospital Minimal Moderate Intensive Highly Spl.

Care Care Care Care

Primary Hospital 70% 25 5 -

Secondary
Hospital 65% 30 5 -

Tertiary Hospital
30% 45 15 10
Special Tertiary
Hospital
10% 25 45 20
 one should ensure that there is sufficient staff
to cover all shifts, off–duties, holidays.
 The Forty- Hour Week Law (Republic Act
5901), provides that employees working in
hospitals with 100-bed capacity and
up will work only 40 hours a week.
 Employees working in agencies with less than
one hundred-bed capacity or in agencies
located in communities with less than one
million populations will work forty-eight
hours a week and therefore will get only one
off-duty a week.
Rights and Privileges 40 Hours 48 hours
Given Each Personnel
per year

Vacation Leave 15 15
Sick Leave 15 15
Legal Holidays 10 10
Special Holidays 2 2
Special Privileges 3 3
Off-Duties as per R.A. 104 52
5901
Continuing Educational 3 3
Program
------- -------
Total Non-Working Days 152 100
Per Year
Total Working Days Per 213 265
Year
Total Working Hours Per 1704 2120
Year
 Average number of leaves taken each year------15
 Vacation Leave ------------------------------------10
 Sick Leave -------------------------------------------5

 Holidays --------------------------------------12
 Special Privileges as per CSC MC#6 s.1996 ------3
 Continuing Education Program for Professionals - 3

 Total Average Leaves ----------------------------33

 Itwill be noted that although an employee is
entitled to 15 days sick leave and 15 days
vacation leave, 12 holidays, 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.

 This will be 0.15 per person who works 40

hours per week

 0.12 per person for those working 48 hours

per week.
 Distribution by shifts

 Studies have shown that the morning or day

shifts need the most number of nursing
personnel at 45 to 51 percent;

 for the afternoon shift 34 to 37 percent;

 and for the night shift 15 to 18 percent.

Case : Find the number of nursing
personnel needed for 250
patients in a tertiary
hospital.
Categorize the patients
according to levels of
care needed.
 250 pts x .30 = 75 patients needing minimal
care.
 250 pts x .40 = 112.5 patients needing
moderate care
 250 pts x .15 = 37.5 patients need intensive
care
 250 pts x .10 = 25 patients need highly
specialized nursing
care
------
250
Findthe number of
nursing care hours (NCH)
needed by patients at
each level of care per
day.
 75 pts x 1.5 (NCH needed at Level I) = 112.5 NCH/day

 112.5 pts x 3 (NCH needed at Level II) = 337.5 NCH/day

 37.5 pts x 4.5 (NCH needed at Level III) = 168.75 NCH/day

 25 pts x 6 (NCH needed at Level IV = 150 NCH/day

-------------
Total 768.75
NCH/day
Findthe total NCH
needed by 250 patients
per year.
768.75x 365 (days/year)
= 280,593.75 NCH/year
Findthe actual working hours
rendered by each nursing
personnel per year.

8 (hrs/day) x 213 (working

days/ year) = 1,704 (working
hours/year)
Findthe total number
of nursing personnel
needed.
  Total NCH per year = 280,593.75 = 165

 Working hrs/ year = 1,704

 Relief x Total Nsg Personnel = 165 x 0.15 = 25
 Total Nursing Personnel needed 165 + 25 = 190

 Categorizeto professional and non – professional

personnel. Ratio of professionals to non-
professionals in a tertiary hospital is 65:35

 190 x .65 = 124 professional nurses

 190 x .35 = 66 nursing attendants
Distribute by shifts.
 124 nurses x .45 = 56 nurses on AM shifts
 124 nurses x .37 = 46 nurses on PM shifts
 124 nurses x .18 = 22 nurses on night shifts
Total 125 nurses

 66 Nsg attendants x .45 = 30 Nursing attendants

on AM shifts
 66 Nsg attendants x .37 = 24Nursing attendants
on PM shifts
 66 Nsg attendants x .18 = 12 Nursing attendants
on night shifts
 Total 66 Nursing attendants
 Placement

Proper placement fosters personal growth,

provides a motivation climate for the
employee, maximizes productivity and
organizational goals have better chances of
being met.

Inappropriate placement often results in

frustration, poor quality of work, reduced
organizational efficiency, rapid turn-over,
and poor image for the agency.
Factorsthat may
be considered :
past experience and training,

culture of the clientele,

decision-making skills,

communication skills.
 New staff nurses can be place in units where
they can work at their own pace and feel
more confident when supervised

 experienced and well- trained nurses adapt

faster, feel confident in their skills and
abilities to contribute maximally to the
organization’s vision, mission, philosophy,
goals, and objectives.

 THERE IS still need for orientation to their

new jobs/ being transferred
 malenurses are seldom placed in
Maternity Units where women are
not comfortable when cared by
male nurses (inhibitions)