GUSRINA K.P.

, MSN
 METHOD OF ASSIGNMENT
1. Total patient care nursing / case method
2. Functional nursing
3. Team and modular nursing
4. Primary nursing
5. Case management
 TOTAL PATIENT CARE

Charge
nurse

Nursing Nursing
staff staff

Patients Patients Patients Patients Patients Patients

 FUNCTIONAL NURSING

Charge
nurse

RN RN
Nursing
medication treatment Clerical
assistants
nurse nurse

PATIENTS
 TEAM NURSING

Team RN, LPN,

Patients
Charge leader PCA
nurse Team RN, LPN,
Patients
leader PCA
 PRIMARY NURSING

Healthcare org.
Physician Charge nurse
resources

Primary Nurse

patients

Associate nurse Associate nurse Associate nurse

(am) (pm) (as needed)
 CENTRALIZED

STAFFING
DECENTRALIZED
 TERMINOLOGY
Staffing distribution Staffing mix

• Determination of • Ration of RNs to

number of other personnel
personnel (ex: a shift on 1
allocated per shift unit might have
(ex: 45% days, 35% 40% RNs, 40%
evenings, 20% LPN/LVN and 20%
nights). other)
FULL TIME EQUIVALENT (FTE)
Number of hours work for which a full time
employee is scheduled for a weekly period.

Ex : 1 FTE = 8 Hr in per day in a week = 40 hr

in a week
1 FTE = 2 part timer (@ 20 hours a week)
56 hours  1.4 FTE  more than one person
 WORKLOAD MEASUREMENT
TOOLS
1. Nursing Care Hours (NCH) per patient-day (PPD)

NCH / PPD = Nursing hours worked in 24 hrs

patient census
 NCH/PPD
NCH / PPD = Nursing hours worked in 24 hrs
patient census

Case : There are 15 staffs that work on 12

hours shift. The patient census is 30.

Calculate the NCH/PPD

NCH / PPD = (15 X 12 ) / 30
= 6 NCH/PPD
 NCH/PPD
to project daily staffing
6 NCH / PPD = Nursing hours worked in 24 hrs
patient census

 30 pt x 6 hrs/pt = 180 hours of care /day

 180/12 hr shift = 15 nurses needed
 If same census and acuity of patient ??
 2. Patient Classification
Systems (PCS)
Grouping of patients according to specific
characteristics that measure acuity of
illness, because using the numbers of
patients alone has proved to be an
inaccurate method for determining nursing
care assignments
 Sample of PCS
Area of Care Category I Category II Category III Category IV
Eating Feeds self or Needs some help Cannot feed self Cannot feed self
needs little food in preparing; may but is able to and may have
need chew and swallow difficult swallowing
encouragement

Grooming Almost entirely Needs some help Unable to do Completely

self-sufficient in bathing, oral much for self dependent
hygiene, hair
combing, and so
forth

Excretion Up and to Needs some help In bed, needs Completely

bathroom alone in getting up to bedpan placed or dependent
or almost alone bathroom or using urinal place; may
urinal be able to
partially turn or lift
self
 Calculating staffing needs
Category I acuity level 3.2 NCH/PD for 7a - 7p :
Category II acuity level 5.6 NCH/PD 172.8 hrs. X 60% (days)
Category III acuity level 7.0 NCH/PD = 103.68 NCH
Category IV acuity level 10.0 NCH/PD
103.68/12 = 8.64
*How many NCH are needed for the next 24 hours? nurses needed
 Category I 3.2 NCH/PD X 3 pts. on day shift
 Category II 5.6 NCH/PD X 7 pts.
 Category III 7.0 NCH/PD X 12 pts. for 7p-7a:
 Category IV 10.0 NCH/PD X 4 pts. 172.8 hrs X 40%
(evenings) =
Answers: 69.12 NCH
 Category I 3.2 NCH/PD X 3 pts. = 9.6 NCH 69.2/12= 5.77
 Category II 5.6 NCH/PD X 7 pts. = 39.2 NCH nurses needed
 Category III 7.0 NCH/PD X 12 pts.= 84.0 NCH on evening shift
 Category IV 10.0 NCH/PD X 4 pts. = 40.0 NCH

172.8 NCH
The Relationship between Staff Mix,
Assignment Methods, and Staffing
Must examine the staff mix and patient
care assessments to ensure that
appropriate changes are made in staffing
and scheduling policies
 E.g. Decreasing licensed staff, increasing
numbers of unlicensed assistive staff, and
developing new practice models have a
tremendous impact on patient care
assignment methods
Recruitment
The process of or actively seeking out or
attracting applicants for existing positions.
- Retention  organization stable
- Turnover ratio : rate at which employees
leave their jobs for reasons other than
death or retirement. The rate is calculated
by dividing the number of employed in
the unit during the year and then
multiplying by 100.
Interviewing
A verbal interaction between individual for
a particular purposes

Limitations of Interviews  validity and

reliability of interview are inconsistent
 Overcoming interview
limitations

Developed a
Use scenarios to
Use a team structured interview
determine decision
approach format for each job
making ability
classification

Provide training in
Conduct multiple effective
interviews interviewing
techniques
 Seleksi

Adequate applicant Pre employment Completion of

pool screening application

Reference checks ; pre

employment testing; Notification of
Employer decision
physical examination; applicants
employment interview
Placement / Penempatan
 Appropriate placement  important for
org. function & new employee success.
 Faulty placement  reduced org,
efficiency, increased attrition, threats to
org. integrity and frustration of personal
and professional ambitions.
 Induksi / Indoctrination
Planned, guided adjustment of an
employee to the organization and the work
environment.
Purpose:
1. Establish favorable employee attitudes
toward organization, unit & department
2. Provide info & edu for the position
3. Feeling of belonging & acceptance
Phases of Indoctrination

Induction Orientation
•Take place after •Activities more
the employee has specific for the
been selected but position
before performing Socialization
the job role
•General
information about
org.
 Performance appraisal
An appraisal of how well employees perform the duties
of their job as delineated by the job description

Factors for effective performance appraisal

Appraisal should be based on standard

• Employee should have input into development of standard

Employee must know standard in advance

• Employee must know sources of data gathered for the appraisal

Appraiser should be someone who has observed

employee’s work
• Appraiser should be someone the employee trusts and respects
 Performance appraisal tools
Trait rating scales •Rates an individual against some standard

Job dimension scales •Rates the performance on job requirements

Behaviorally anchored •Rates desired job expectations on a scale of importance

rating scales (BARS) to the position

•Rates the performance against a set list of desirable job

Checklists behaviors

Essay •A narrative appraisal of job performance

Self-appraisals •An appraisal by performance by the employee

Management by •Employee and management agree upon goals of

objectives performance to be reached

Peer review •Assessment of work performance carried out by peers