Help with information on patient ratio staffing

classicdame, MSN, EdD · May 25, 2011

Texas requires each hospital to have a Safe Staffing Committee. When ours first convened we spent time learning what the standards were for various types of nursing. Bottom line, every patient is different. If you set a specific ratio then the patient may not get the care they need and the nurse may be overworked. Or should I say, MORE overworked? Some recommendations by professional nursing organizations provided us with evidence based references to give to Administration. But the truth is, if people do not want to come in there is not a lot you can do. If you hire too many, then on low census days people get sent home. Hard to plan a budget (home and job) around that.

nursej22, MSN, RN · May 25, 2011

Here a link explaining the system in Washington State.

http://www.wsna.org/Topics/Safe-Nurse-Staffing/

Our hospital safe staffing committee had representation from each department as well as management. Granted, the administration did not have to accept the committee proposals, but they did.

In our facility, it is ultimately up to each department manager to determine their staffing/ratios and skill mix based on patient needs and budget.

I fear with the next fiscal year we will losing a lot of support staff, and though the RN staffing may remain the same, we will be doing more non-nursing tasks.

Esme12, ASN, BSN, RN · May 25, 2011

They are studied by many groups including Joint Commision and the professional oranizations for specialties....

http://tinyurl.com/3wez9cu

maddymc55 · May 25, 2011

are there any Massachusetts nurses? I know I spoke with a NICU nurse and they used some type of grid? I didn't quite understand it?

Esme12, ASN, BSN, RN · May 25, 2011

are there any Massachusetts nurses? I know I spoke with a NICU nurse and they used some type of grid? I didn't quite understand it?

Basically......for most institutions they determine staffing on a pre-fixed grid or matrix. These standards are based upon national standards and commonly refered to as "Standard of care" The amount of nurses and ancillary staff increase and decrease according to the number of patients on a given unit. The nature of the unit is considered when the numbers are set and budget constraints are also factored into the equasion.

Example: A typical med/surg floor (not actual numbers)

7-3 6-12 patients 2RN's 1CNA 1 SEC now those numbers change.......if there are 6 patients I would have 2 nurses and give the option of either the aide or the secretary. which ever is canceled I would pu the other on call or find somewhere else in the house to use them.

13-18 patients 3RN 1.5CNA 1 SEC

for the off shifts.....evenings and nights the RN patient ratio changes for more patients per nurse but more ancillary (CNA's) avilable,,,,supposedly because the patients sleep all night (LOL)

and so on.... for the critical areas like ICU usually it is 2RN's per patient and an assessment for critical instability or critical equiptment. Emergency Departments are staffed reguardless of census as one never knows what is comming through the door.......usually 4 or 5 patients to 1RN and traumas are considered 1 or 2 RN's per patient with EMT's and Paramedics and techs the down side is that's it when crap hits the fan.

I hope that helps.....PM me if you have questions......I am sure I have an old matrix or 2.....

maddymc55 · May 26, 2011

Hi,

Do you have a grid you can email me? That would be great! Thanks!!

maddymc55 · Jun 14, 2011

Could you possibly resend that martix information. I think I lost it? Thanks so much for your help!