Scheduling and Staffing
- 5 R.N. 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. Who uses a walker and requires assistance to the bathroom and ADLs
- Room 2312 Fredrick is a 57-year-old 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 a new-onset D.M. 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 D.M. since he was a 10-years-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 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.
|R.N. 1||R.N. 2||R.N. 3||R.N. 4||R.N. 5|
|Room #||Acuity||Room #||Acuity||Room #||Acuity||Room #||Acuity||Room #||Acuity|
|LPN 1||LPN 2||CNA 1||CNA 2||Staff
· 5 R.N.
· 2 LPN
· 2 CNA
· Six acuity level 1
· 8 acuity level 2
· 9 Acuity 7 vol 3
· seven acuity level 4
|Room #||Acuity||Room #||Acuity||Room #||Acuity||Room #||Acuity|
Directing Staff to Assigned Roles.
Nursing practitioners play a critical role in the delivery of health care. Nursing staffing can be described as the selection, training, motivation, and retention of nursing practitioners within an institution. To date, nursing is significant in most healthcare institutions (Ramsey et al., 2018). Short staffing has been attributed to draining nurses on duty physically, mentally, and emotionally. This results in an overall deteriorating healthcare quality health care, with numerous clinical errors being observed. Staff scheduling is critical in addressing these concerns. Staff scheessentialing is essential in assigning nursing practitioners manageable working hours and shifts, thus reducing the chances of fatigue that may impede the delivery of quality care to patients.
The patient-based acuity model, unlike the traditional model of schedule, which was based on the number of presenting patients, focuses more on the complexity of the presenting and the patient’s health care needs. Patiety can be described as the intensity of providing a nurse to each patient (Lake et al., 2020). The patient-based acuity model is established because patients presenting to various clinics have healthcare needs that should be prioritized. It also appreciates that different nursing practitioners have varying knowledge and skills based on their education levels and years of experience. Therefore, nursing practitioners with higher academic qualifications, skills, and experience are assigned to patients with more delicate healthcare needs and vice versa.
In our case scenario, we have six patients with an acuity level of one. This patient has essential daily assistance and requires little or no advanced health care services. Therefore, the nursing assistants were assigned to look after these patients. Patients with an acuity level of two have requirements that are a bit more complex. The patients in this category have conditions such as diabetes mellitus that require constant glucose monitoring and drug administration. More excellent knowledge and skillsets are paramount at this acuity level. Licensed practice nurses were assigned to care for patients in this category. Patients with an acuity level of three and four had life-threatening conditions such as stroke, cancer, COPD, and myocardial infarction, among others. These conditions required a higher level of care. Registered nurses were, therefore, assigned to these patients. Knowledge, skills, and expertise are critical in determining the nursing practitioners to assign each patient using the patient-based acuity model, a crucial part of the scheduling process highlighted above.
Communication with Care Providers.
Communicacriticaln is a critical component of the health care delivery system. In this scenario, effective communication between the staffing manager and the care providers involved is vital. Communication should be clear, precise, non-ambiguous, and timely (Burgener, 2020). This will ensure that each care provider fully coheirs or her responsibilities within the shift and what is expected of them within that particular shift. Communication can be done via several channels. Nurses can be informed of their shifts and responsibilities verbally. The management may also employ the use of electronic mail for every and every care provider of their shifts while highlighting their duties within that shift. A duty roster can also be put up to indicate the schedule of each care provider.
Ensuring Client Equity.
Equity in health crucial is a crucial component. Equity entails providing the highest quality care whenever patients need it without discrimination (Jensen et al., 2021). provider-to-patientto patient ratio of 1:3 ensured that all patients were always in contact with or close to a care provider. This is critical in minimizing fatigue in care, resulting in numerous errors during care provision. An increased contact time between patients and care providers is critical in care quality and, consequently, improved health outcomes (Brooks Carthon et al., 2019). The patient-based acuity model also ensured that allocation of care providers was done based on the priority of patients’ needs. This ensured that no patient was discriminated against.
Brooks Carthon, J. M., Hatfield, L., Plover, C., Dierkes, A., Davis, L., Hedgeland, T., Sanders, A. M., Visco, F., Holland, S., Ballinghoff, J., Del Guidice, M., & Aiken, L. H. (2019). Association of Nurse Engagement and Nurse Staffing on Patient Safety. Journal of Nursing Care Quality, 34(1), 40–46. https://doi.org/10.1097/NCQ.0000000000000334
Burgener A. M. (2020). We are enhancing Communication to Improve Patient Safety and to Increase Patient Satisfaction. The health care manager, 39(3), 128–132. https://doi.org/10.1097/HCM.0000000000000298
Jensen, N., Kelly, A. H., & Avendano, M. (2021). Health equity and health system strengthening – Time for a WHO re-think. Global public health, 1–14. Advanced online publication. https://doi.org/10.1080/17441692.2020.1867881
Lake, E. T., Staiger, D. O., Cramer, E., Hatfield, L. A., Smith, J. G., Kalisch, B. J., & Rogowski, J. A. (2020). Association of Patient Acuity and Missed Nursing Care in U.S. Neonatal Intensive Care Units. Medical care research and review: MCRR, 77(5), 451–460. https://doi.org/10.1177/1077558718806743
Ramsey, Z., Palter, J. S., Hardwick, J., Moskoff, J., Christian, E. L., & Bailitz, J. (2018). Decreased Nursing Staffing Adversely Affects Emergency Department Throughput Metrics. The western journal of emergency medicine, 19(3), 496–500. https://doi.org/10.5811/westjem.2018.1.36327
Welton J. M. (2017). Measuring Patient Acuity: Implications for Nurse Staffing and Assignment. The Journal of Nursing Administration, 47(10), 471. https://doi.org/10.1097/NNA.0000000000000516
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Scheduling and Staffing
Collaborate in healthcare delivery systems settings for improved patient outcomes.
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 must provide a 12-hour shift of services to 30 clients with a high understanding of the 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 client’s needs. You will use the created template.
table and I page paper
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.
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