Patient Sitters

[cjalston]

Hi,

I am wanting to find out how sitters are counted in the productivity index on the Med-Surg unit. Are they considered as part of the staff on the floor so they cannot be replaced if pulled from the floor to set? What is the average nurse to patient ratio on the Med-Surg floors and how does using staff for sitters impact those numbers? Do you use acuity or a strict matrix for staffing. In other words I'm allowed an 8.4 for my PCH and regardless of staffing needs I'm expected to stay at or below that 8.4. Just want to know your thoughts.

[Kaltia]

If you have sitters often enough even consider this you're doing well

Unless it's a 1 to 1, sitters are either family members, friends or hired by family or staff from the facility the patient came from

[Nik.S.RN]

I work as a house supervisor, I do not know exactly how productivity is worked out, but I know we staff by acuity, assigning a number 1-5 to patients (5 is most care, there are never any 1s or 2s - otherwise why are they there?), we then have a math equation to solve so that icu patients are assigned the most care hours, then tele, then m/s (we have a combined unit - small rural hospital). We also have a staff matrix, to sort of double check our numbers. If there is a large gap between the two, we report on staffing sheets a short narrative or comment such as: high acuity patients, 6 total care and 6 confused patients, 1 suicide watch, 2 vented patients, 2 fresh postops w/ blood transfusions ordered....etc. - so that staffing numbers make sense to our director

To answer your question, we do not "count" the sitter in our "actual staff" numbers, but there is a section on our staff report to indicate that we are staffing a sitter. Our sitters are usually a CNA, or more rare - a nurse from a low census unit, but sometimes a respiratory therapist, maintenance person or housekeeper...etc.

Today we had 8 patients (4 m/s, 4 tele), per staffing grid/matrix it called for 3.7 staff, acuity called for 4.0 staff, we had 3 RNs, 1 CNA and 1 Sitter...the sitter (a CNA) was/is not counted as part of the floor staff.

[glenndagrier]

Nik,

Would you be willing to share your acuity system and staffing matrix? I am looking for a system to adopt.

Glennda

[TeeKay12]

We assign by population matrix. We have the ability, with managerial approval, to increase staff based on acuity. Sitters are culled from our PCTs, if needed. We try to not use them, relying on family members and regular staffing. We rely heavily on bed alarms, open doors, and frequent rounding. Our matrix allows up to 6 patients an RN (med/surg floor), but try to keep assignments lower for those caring for confused/combative/heavy cases.