Nurse Staffing Research Paper

Types of Staffing

In order to care for equal patient loads, understanding the types of staffing is a necessity to assure staffing is adequate. Development of a staffing grid that works everyday will be a huge challenge. There are several ways to arrange a staffing grid so there is adequate resources to care for the patient acuity level. Scheduling can base staffing on three styles: acuity, nurse to patient ratio, and budget. A combination of two or three of these styles makes an ideal base.

Budget Based Staffing

Budget based staffing occurs when nursing staff is divided up according to nurse hours per patient days. This type of staffing grid accounts for census at midnight each night. It does not take into concern admissions or discharges per day. For example, if a medical unit has ten patients at midnight and staffing calls for one nurse for every five patients. This would mean two nurses are staffed each shift. However, throughout the day patients come and go and at five pm there are fifteen patients on the unit. Now, two nurses have seven or eight patients each versus the five they staffed for. This type of budget is too risky when looking at nurse overload and patient safety.

Nurse to Patient Ratio Staffing

This type of staffing is based solely on the number of patients on the unit.

This type of staffing is usually looked at three times per day, it pairs nurse to patients based on a ratio. A unit that staffs 1:5 means one nurse for each five patients. This model prevents uneven team numbers but does not take into consideration patient acuity. For example, one nurse may have three critically ill patients in their team of five, whereas, another nurse may have five intermediate level of care patients. While each nurse has the same number of patients, the teams are unequal in terms of acuity. In this scenario, one nurse definitely has a larger workload which makes stress levels

high.
Patient Acuity Staffing

Patient acuity staffing considers each patient’s level of acuity prior to assigning that patient to a team. Acuity is determined by nursing care such as diagnosis, IV therapy, ventilator treatment, confusion, multiple comorbid conditions, etc. This type of staffing is also looked at three times per day. This staffing is more in tune to nurse to patient workload versus nurse to patient ratio or number. This type of staffing keeps patient loads similar.

Which Grid is The Best?
Every hospital and healthcare organization is different. Each unit within that organization is unique in the types of patients they care for. Because of the distinct differences in these organizations most facilities don’t stick to one model or another but use a combination of models. This is the most efficient when trying to keep costs contained without inadequately staffing the nurses. What model or combination of models works for one hospital may not work for all the hospitals in the nation. It is the responsibility of each organization to come up with a grid that works for them.