Leadership and Professional Identity Staffing- Scheduling and Staffing

Leadership and Professional Identity Staffing- Scheduling and Staffing

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Staffing Available

5 RN 2 LPN 2 NA

30 patients

Acuity Level 1 – 6 Patients

Room 2301 Susan is a 93-year-old who fell at home and is waiting for nursing home placement; she uses a walker and requires assistance to the bathroom and ADLs

Room 2312 Fredrick is a 57-year-old who is recovering from a knee replacement, needs educational reinforcement and is going home today.

Room 2319 Joshua is a 63-year-old who was in for cardioversion and is going home today.

Room 2329 Brian is a 49-year-old who has been diagnosed with hypertension and Alzheimer’s disease who wanders off the unit and needs assistance with ADLs.Room 2304 James is a 95-year-old who has osteoarthritis and needs help getting out of bed, bathing, and dressing.

Room 2307 Francis is a 39-year-old who will be discharged today. She received discharge teaching yesterday about her ruptured appendix wound and wants to review the care instructions before she leaves.

Acuity Level 2 – 8 Patients

Room 2302 Brooke is a 33-year-old who was admitted with new-onset DM with uncontrolled blood sugars. She has started on new medications, including insulin, and needs additional patient and family education.

Room 2311 Mark is an 83-year-old who is in isolation for MRSA and is on IV antibiotics and ten other medications.

Room 2320 Jeffrey is a 63-year-old who is non-compliant with his medications and came in with hypertension and crackles in his lungs. He has daily labs and has a wound on his left foot.

Room 2330 Leslie is a 46-year-old who had unstable angina and had a cardiac catheterization yesterday late afternoon and stayed over for observation.

Room 2305 Traci is a 72-year-old who has a history of heart disease, a history of myocardial infarction, and mild dementia.

Room 2308 Alecia is a 33-year-old who was experiencing chest pain and is scheduled for a stress test later today.

Room 2303 Theodore is a 22-year-old who has had DM since he was a 10-year-old and requires medication adjustments.

Room 2318 Bruce is a 45-year-old who was placed in isolation for C-Diff and is on several IV medications.

Acuity Level 3 – 9 Patients

Room 2306 Amelia is an 83-year-old after a stroke and requires total care.

Room 2313 Audrey is a 78-year-old with newly diagnosed COPD.

Room 2317 Abigail is a 90-year-old who is a diabetic with a chronic leg infection.

Room 2328 Roxanne is an 82-year-old with newly diagnosed lung cancer.

Room 2322 Nancy is a 56-year-old with chronic kidney disease and on peritoneal dialysis.

Room 2323 Dennis is a 35-year-old who was admitted with right upper quadrant pain that radiates to the right shoulder.

Room 2314 Roger is a 46-year-old who is wasted and malnourished. She has severe diarrhea.

Room 2309 Terry is a 59-year-old who has bladder cancer with painless hematuria.

Room 2310 Barry is a 54-year-old with a history of mitral valve regurgitation.

Acuity Level 4 – 7 Patients

Room 2315 Karen is a 45-year-old who had an acute myocardial infarction with percutaneous coronary intervention.

Room 2321 Fredrick is a 43-year-old who was admitted after an overdose and required close monitoring.

Room 2327, Samantha is a 57-year-old with severe abdominal pain with no bowel sounds.

Room 2324 Robbie is a 62-year-old who has been vomiting and having pain in the abdomen.

Room 2325 Jenny is a 58-year-old MVA who has a tracheostomy.

Room 2326 Annette is a 68-year-old who had a bowel resection and colostomy.

Room 2316, David is a 54-year-old with weakness and a decreased level of consciousness.

RN 1		RN 2		RN 3		RN 4		RN 5
Room #	Acuity	Room #	Acuity	Room #	Acuity	Room #	Acuity	Room #	Acuity
2316	4	2324	4	2321	4	2315	4	2321	4
2326	4	2327	4	2310	3	2309	3	2314	3
2323	3	2322	3	2328	3	2317	3	2313	3
LPN 1		LPN 2		CNA 1		CNA 2		Staff ·  5 RN ·  2 LPN ·  2 CNA 30 patients ·  6 acuity level 1 ·  8 acuity level 2 ·  9 acuity level 3 ·  7 acuity level 4
Room #	Acuity	Room #	Acuity	Room #	Acuity	Room #	Acuity
2306	3	2330	2	2302	2	2301	1
2318	2	2305	2	2304	1	2312	1
2303	2	2311	2	2307	1	2319	1
2308	2	2320	2			2329	1

The direction of staff to the assigned roles

The optimal healthcare delivery process depends on the individual input of every nurse provider towards attaining safe, quality, and effective care. However, this can be impeded by healthcare provider-related factors such as work burnout attributable to a staff shortage (Teng et al., 2016). Whereas staff shortage remains a critical issue in the healthcare delivery system, structural organization of the available staff could enhance their output without burdening their work processes. Staff scheduling is a particularly important factor in enabling this.

Unlike the conventional staff scheduling that assigns nurses in shifts according to the number of patients, the patient acuity-based staffing model assigns nurses depending on their level of need (Nguyen, 2016). The stratiform available in nursing practice confers each nurse qualification level a specific set of knowledge and skills required in the various levels of care. Registered nurses are better trained, better qualified, and possess better skills required in the management of patients with higher acuity scores. Their expertise could, therefore, be adopted in patients who require more critical care as informed by higher acuity scores (Liang & Turkcan, 2015). In this hospital case, all the patients who scored 3 or 4 on the acuity assessment require specialized care that could adequately be matched by the expertise of registered nurses. These cases included a critical cardiovascular case patient, an overdosed patient, and a patient who has had a tracheostomy, among others, all of whom require critical care.

On the other hand, licensed practice nurses (LPN), possess skills that could be utilized in the management of patients who require less critical care. Therefore, patients with an acuity score of 2 could adequately be managed by LPNs. In this case, all patients with an acuity score of 2 were assigned to LPNs. Expertise provided by nurse assistants can be used in the management of patients with fewer care requirements, as informed by acuity scores of 1.

The communication process that assures the best care outcomes

Effective communication remains the cornerstone of a safe and efficient care process. Communication entails the flow of information between two parties. In this case scenario, communication will involve the staffing officer and the nine employees expected to hold the shift in question. The goal of this communication is to make these employees understand the expectations of the care process they are about to undertake as well as their roles throughout the entire exercise. In this regard, the communication should be clear, concise, and easily understandable (Webb, 2018). This will ensure that the employees get the subject being communicated to them.

The significance of this communication is to prevent confusion in roles that may otherwise reduce the efficiency and effectiveness of the care process. The communication should, therefore, be made in a manner that ensures all these employees get the message. The utilization of posters and internal memos can be beneficial in this regard. These posters or internal memos could be emailed to the individual nurses or printed and posted on a noticeboard at the entrance of the inpatient facility. The nurses should also be informed to check the duty roster to confirm the responsibilities granted to them for this particular shift.

Ensuring client equity in care delivery services

Equity healthcare provision is dependent on the ability to meet patient care needs at their levels of need. It entails equal distribution of healthcare resources to all patients who need it to confer them the full potential to liberate themselves from their incarcerations and suffering. An acuity score often stratifies patients according to their levels of healthcare needs. To ensure equitable healthcare provision to all these patients, commensurate care should be granted to them. This staffing schedule adequately ensures this is attained by allocating nurse staff to patients according to their healthcare needs (van Roode et al., 2020). As evident above, more qualified, better-skilled nurses were assigned to patients with higher acuity scores. Less critical patients, on the other hand, were assigned to nurses with commensurate expertise in their care process. This not only ensures that each patient’s needs are met but also ensures that healthcare services are distributed equitably. Additionally, the nurses’ assignments were done in a manner that ensured that the nurse-to-patient ratio was 1:3. The significance of this is that it enables better patient-to-nurse contact that ultimately enables the realization of optimal care. This, as well, is an exhibition of equitable distribution of care.

 References

Liang, B., & Turkcan, A. (2015). Acuity-based nurse assignment and patient scheduling in oncology clinics. Health Care Management Science, 19(3), 207-226. https://doi.org/10.1007/s10729-014-9313-z

Nguyen, A. (2016). Acuity-based staffing. Nursing Management, 46(1), 35-39. https://doi.org/10.1097/01.numa.0000459555.94452.e2

Teng, C., Shyu, Y., Chiou, W., Fan, H., & Lam, S. (2016). Interactive effects of nurse-experienced time pressure and burnout on patient safety: A cross-sectional survey. International Journal Of Nursing Studies, 47(11), 1442-1450. https://doi.org/10.1016/j.ijnurstu.2010.04.005

van Roode, T., Pauly, B., Marcellus, L., Strosher, H., Shahram, S., & Dang, P. et al. (2020). Values are not enough: qualitative study identifying critical elements for prioritization of health equity in health systems. International Journal For Equity In Health, 19(1). https://doi.org/10.1186/s12939-020-01276-3

Webb, L. (2018). Exploring the characteristics of effective communicators in healthcare. Nursing Standard, 33(9), 47-51. https://doi.org/10.7748/

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Scheduling and Staffing
Competency
Collaborate in healthcare delivery systems settings for improved patient outcomes.
Scenario
You are making a staffing assignment knowing that you are short-staffed. You have five registered nurses (RNs), two licensed practical nurses (LPNs), and two nursing assistants. Those nine employees need to provide a 12-hour shift of services to 30 clients with a high acuity, which requires a ratio of nurse to client at 1:3.

Client acuity level
Six acuity level 1
Eight acuity level 2
Nine acuity level 3
Seven acuity level 4
You will use the acuity-based staffing model to develop the staffing assignment based on the needs of the clients. You will use the created template.

NUR2832_Staffing

Instructions
As you create this assignment, include the following in an email to your manager to justify your short-staffing plan:
Complete the staffing assignment based on the acuity level.
Defend how you would direct the staff to their assigned roles for this shift and provide a rationale for the staffing assignment.
Describe how you would communicate with each level of care provider to ensure the best outcomes possible.
Address how you would ensure client equity in the delivery of services.
Provide stated ideas with professional language and attribution for credible sources with correct APA citation, spelling, and grammar.
Resources
To assist in completing this assignment, review the article titled Patient Acuity Model.
Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.
Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:
Jstudent_exampleproblem_101504