Nurse hours per patient day

Nurses General Nursing

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Does anyone know of a resourse for nursing hours per patient day? We currently have some set up, but no one here is able to tell me where these numbers came from. I have surfed the net but am unable to find anything. Can someone point me in the right direction?

Thanks,

Shellie

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havent heard of that. we dont do that here in uk

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I would like to know more about HPPD, too. I'd like to know who came up with this and what kind of studies or "facts" back these up, because they are not in the realm of reality when it comes to staffing.

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Hours per patient day is based on a formula with input from average daily census, staffing complement, acuity of patients.

HPPD is used when determining staffing mix and open positions, I believe. I would post this question of the nursing managment board and see if they might be more helpful.

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Hello,

I don't know where you are located at but at least in the states I've worked the nursing hours PPD are a formula of:

A) straighttime- X hours per patient in the facility.

B) wieghted- hours per patient acuity (ie. the higher the care for a resident the more hours they require, set up by case mix/rug scores)

Some states have a set number of hours required by law for each resident, or general staffing guides. They can be set to include all nursing (licensed and CNA) or split hours (xhours for licensed and x for CNA) or even set just by licensed staff. None of these hours include staff that is not invoulved in direct care in some way Ie DON doesn't count, nor does the other "desk or clip boarders".

Dependant on your location these staffing factors can be found in the regulations for your facility type, or averages for the area can be found on the CMS website in nursing home compare.

Most of the time these numbers are set to be the MINIMUM staffing allowed. Facilities tend to "shoot" for the closest to these numbers without goining under to save $$$$$$. (at least that is what I and the other managers had to do or get the budget lecture)

I hope this helped,

peter

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Consult your CNO, or VP/Nursing. He/she can tell you exactly how the hours are calculated in your organization.

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I'm the manager of what is termed a Med-Surg unit, however, our case mix regularly includes ICU candiates as well as Cardiac Care Step down patients for various reasons. We are more of a "fly by the seat of your pants" orginization. Administration really has no idea what it takes to provide the excellent care my nurses provide. I'm looking for a realistic formula to assign patient acuity. The one we have is a) not used, and b) so vague it really doesn't help. If anyone knows of a resource (that won't cost me a couple of hundred bucks out of my own pocket) I would sure appreciate your insight.

Thanks!

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Look at the CA mandated Nurse-patient ratios, these are the same baselinr ratios the Magnet surveyors look for. In order to effectively judge your census you need some form of a acuity system.. because Med/Surg Unit are all a little different. If you facility uses Solucient data this can help you to compare with other facilities.

At my current hosptial we use a paper acuity system that the shared governance team developed, On our Med[surg unit of 35 out Hours Per Patient Day(HPPD) is 9.26.

7a to 11P nurse patient ratio is 4-5 (if you start with 5, you are assigned a patient that wioll be discharged and if you start with 4 you get an admission) althougt it does always work exactly fair it focuses on being fair with the flow of patients. We have a CNA for each 7-10 patients and a Charge Nurse that serves as an Inteventionl and patient flow coordinator. There is also a Clinical Manager available when needed on the floor.

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We use a system called GRASP... t's great & I know it is available in the States (at a cost of course) Hope you find the link helpful

http://www.graspinc.com/

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I manage a 12 bed Observation unit in Hawaii. We have been budgeted with a HPPD of 9.10 based on telemetry unit data. I do not feel that HPPD accurately measures the efficiency of a fast paced observation unit with wild fluctuations in census over 24 hours. What are other units using for work efficiency measurement?

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Do you have a specific tool that you use?

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Grasp does use HPPD.

Unfortunately like Evalysis and the other proprietary acuity systems they will not let nurses in on the conversion formula.

We once labeled every patient a "2" for a week.

The next week labeled them "4".

We got exactly the same census based insufficient staffing. That was before the California staffing law. Here are the regulations. Starting on page 7 are the patient classification system (PCS = acuity) requirements:

http://www.dhs.ca.gov/lnc/pubnotice/NTPR/R-37-01_Regulation_Text.pdf

FAQ answering hospital management questions:

http://www.dhs.ca.gov/lnc/pubnotice/NTPR/R-37-01_FAQ2182004.pdf

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