Hours per patient day staffing

[Shellie RN]

Does anyone know of a resource for nursing hours per patient day. We currently use 8.98 hppd for our MSP, and 4.5 hppd for our Swing Beds. I am looking to see if we are in the high range or low range or just right. We pretty much use this for staffing guidelines with the exceptionof patients who are extremely high in acuity then we staff extra. No one at our hospital can remember where these numbers came from excpet maybe a former CEO said use these. Any help would be greatly appreciated.

Thanks,

Shellie

[live4today, RN]

Don't know Shellie, but I'd venture to guess that no matter what those numbers show....there aren't nearly enough nurses staffing the units in today's hospitals for the heavy patient load....not including all the "killed trees" nurses are mandated to write all over.

[panurse101]

Wow...8.98 hppd..where do you work? We staff at 3.1 hppd. Pa state requires 2.7 hppd. This is really effecting us though...we used to be up anywhere from 5-7 hppd. In fact..since we had to cut back...our restorative program has gone in the toilet..only just this week..have we seen it slowly coming back.

Tracy

[nursemaa]

For our facility, hppd were determined by an acuity collection system, which gathered data over a 2 week period regarding the "average" numbers of patients that fall into various acuity categories. The categories come from the type of care that a patient in a given category needs (assistance with ADL's, IV's, meds, dressings, ambulation, frequency of vitals, amout of time spent monitoring patient status, incontinence, etc). Our tele unit uses 7.7 hhpd, which I'm told is typical for a medical tele unit. ICU/CCU is around 17 hppd. These hppd are multiplied by the midnight census to arrive at a target for paid hours in a 24 hour period, which is divided among the three shifts. For us, the hppd do not include the manager or CNS. This number is then compared to the actual paid hours for the 24 hours (info from payroll) to determine whether you are on target (over or under budget). A staffing grid is established that tells you how many staff can be on for a particular number of patients. Unfortunately, it's based on averages and numbers of patients and does not take into account unforseen things like codes, "needy" patients/families/physicians, sudden changes in patient status, etc nor does it allow for the huge number of admissions and discharges (turnover rate) that may occur after midnight. Sometimes a manger can justify being "over" in staffing and salaries based on these things but it's still frowned on to be over budget. Nursing productivity is difficult (maybe impossible?) to measure but this is typically the kind of system that is used.