# About productive hours per patient day? - page 2

by rrroyer

I'm the manager of a 20 bed ortho/neuro unit and a 29 bed medical/surgery unit. My questions is what are the productive hours per patient day alotted to various units/hospitals across the nation. We just had consultants come...

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That really helped a lot. May I ask what kind of background that you have...the steps you took to become a manager?

Quote from RNPATL
Actually, HPPD stands for hours per patient day.

What this means is the amount of hours permitted or allowed for a nurse to spend with a patient per day (24 hour period). Generally speaking, the HPPD is set by your unit's budget. A nurse manager and the staff nurses are required to work within the confines of these numbers as they render care for the patients. Here is a senario that might help you understand it ....

An HPPD is calculated by the census. So if your unit has a census of 25 patients, then that number is multipled by the unit's HPPD.

Census of 25 multipled by the HPPD of 7.00 equals = 175 hours. The 7.00 is the number that is given to you by upper management and the number that most nurse managers fight over with the CNO to increase.

This means that the nurse manager has 175 hours of nursing time to work with in relationship to staffing the unit. So, If I have 175 hours to work with .... all of my unit's staffing hours must come from this number .... for example:

Assuming a nurse to patient ratio of 1:6 on days and 1:7 on nights and that we are a general medical-surgical unit ... we would staff as follows for this 24 hour period:

Days Shift Staffing Hours

Nurse Managers Hours - 5.73
Charge Nurse 12 hours
(The CRN would take 2 patients)
4 Nurses all 12 hours
2 CNA - 1 for 12 hrs and 1 for 8 hrs
1 Secretary - 12 hours

Total Hours for Days = 92

Night Shift Staffing Hours

Charge Nurse 12 hours
(The CRN would take 5 patients)
3 Nurses all 12 hours
1 CNA for 12 hours
1 Secretary for 12 hours

Total Hours for Nights = 72

Total Hours Per Patient Day for this 24 hour period would be: 170 (rounded)

Sometimes, patient acuity is so high that the nurses can not handle 6 patients on days .... the nurse manager needs to be flexible to staff up if needed to accomodate the needs of the patients. This means that you might go over your allowable hours for the day. However, I usually staff by the pay period .... so, if I am off one day, I try to make it up the other days, if possible .... and always with the help of the nurses.

Hope this helps a little.
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My understanding is that HPPD only include direct patient care givers. Managers and secretary should not count. They should be part of the "administrative" cost. Do others count non-direct care givers?
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The hours I am allotted to run my unit(s) include the manager hours as well as the secretary hours. Some facilities differ with this, but mine are included.
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I am also interested in NICU hppd. Any info, anyone?
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Quote from RNPATL
The hours I am allotted to run my unit(s) include the manager hours as well as the secretary hours. Some facilities differ with this, but mine are included.
Patrick, that was a very good answer. Do you have time to look at your productivity on a daily basis? I feel like I am always behind the 8 ball. With my HPPD, census is my friend--the higher the census the better off I am. Sandie
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Quote from surgery2
Patrick, that was a very good answer. Do you have time to look at your productivity on a daily basis? I feel like I am always behind the 8 ball. With my HPPD, census is my friend--the higher the census the better off I am. Sandie
Hi Sadie .... Yes, I look at my productivity everyday. I have to agree census is our friend as nurse managers. In order for us to meet productivity standards, we need the census. Over the holidays my census fell very low and it was impossible to meet the standards.

What I do in order to look at my staffing standard everyday is I have asked my charge nurses to review staffing every 4-6 hours and document the number and classification of staff on hand. This way, we have a chance of staying on target. In addition, I review the staffing trends every day to make sure we are following our clinical staffing grid. The grid is very giving to my staff and allotes more than ample staffing for our census.

Ensuring a good balance between decent staffing and the budget can be and generally is a real challenge. But, as a nurse first, I have always advocated that we balance our staffing against the needs of the patients. This has worked very well for me and the nurses.

Good luck and let me know if you have any other questions.
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Quote from rrroyer
I'm the manager of a 20 bed ortho/neuro unit and a 29 bed medical/surgery unit. My questions is what are the productive hours per patient day alotted to various units/hospitals across the nation. We just had consultants come and evaluate our productivity. They then suggested lowering our productivity based on "national benchmarks" so I was wanting to compare the real world numbers. Gather my ammunition. ANy help would be appreciated.
Do the figures that everyone is quoting include CNAs and clerks as well as the LPN/ RN. My 42 bed unit is running at 10 HPPD?????
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Quote from liz66
Do the figures that everyone is quoting include CNAs and clerks as well as the LPN/ RN. My 42 bed unit is running at 10 HPPD?????
Is that your budgeted hours or is that the hours you are actually running each day? Wow ... I wish my hours were that high .... right now mine are 7.80 and that includes all my nurses (RN/LPN), CNA's and unit clerks. It also includes my hours and those of my charge nurses. I find it very difficult to work within these hours not only for the nurses on the floor, but also for me as I am the only management level person running these 40 beds (the size of my unit) and also providing educational support.
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Ours does not include management hours or unit secretaries but does include NA's.
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Quote from RNPATL
Actually, HPPD stands for hours per patient day.

What this means is the amount of hours permitted or allowed for a nurse to spend with a patient per day (24 hour period). Generally speaking, the HPPD is set by your unit's budget. A nurse manager and the staff nurses are required to work within the confines of these numbers as they render care for the patients. Here is a senario that might help you understand it ....

An HPPD is calculated by the census. So if your unit has a census of 25 patients, then that number is multipled by the unit's HPPD.

Census of 25 multipled by the HPPD of 7.00 equals = 175 hours. The 7.00 is the number that is given to you by upper management and the number that most nurse managers fight over with the CNO to increase.

This means that the nurse manager has 175 hours of nursing time to work with in relationship to staffing the unit. So, If I have 175 hours to work with .... all of my unit's staffing hours must come from this number .... for example:

Assuming a nurse to patient ratio of 1:6 on days and 1:7 on nights and that we are a general medical-surgical unit ... we would staff as follows for this 24 hour period:

Days Shift Staffing Hours

Nurse Managers Hours - 5.73
Charge Nurse 12 hours
(The CRN would take 2 patients)
4 Nurses all 12 hours
2 CNA - 1 for 12 hrs and 1 for 8 hrs
1 Secretary - 12 hours

Total Hours for Days = 92

Night Shift Staffing Hours

Charge Nurse 12 hours
(The CRN would take 5 patients)
3 Nurses all 12 hours
1 CNA for 12 hours
1 Secretary for 12 hours

Total Hours for Nights = 72

Total Hours Per Patient Day for this 24 hour period would be: 170 (rounded)

Sometimes, patient acuity is so high that the nurses can not handle 6 patients on days .... the nurse manager needs to be flexible to staff up if needed to accomodate the needs of the patients. This means that you might go over your allowable hours for the day. However, I usually staff by the pay period .... so, if I am off one day, I try to make it up the other days, if possible .... and always with the help of the nurses.

Hope this helps a little.

thanks for your incredible explanation. How does this work if your state mandates that you must staff by acuity????