ESTIMATING OF NURSING STAFF

REQUIREMENT Activity Analysis

PRESENTED BY
MRS HEENA MEHTA
S. Y. M.Sc. Nursing

INTRODUCTION
Staffing is one of the major problems of any
nursing organizations whether it to be a hospital,
home health care agency, or another type of
facility.
Nurse staffing methodology should be an orderly,
systematic process, based upon sound rationale,
applied to determine the number and kind of
nursing personnel required to provide the nursing
care as per the standards of nursing practice to a
group of patients in a particular sense.

INTRODUCTION
The end results is the prediction of
the kind and number of staff required
to give care of patients. In practice
the terms staffing and scheduling are
sometimes used interchangeably.
Although they are closely related as
the two sides of a coin there are
practical differences as follows:

INTRODUCTION
Staffing is determining how many
people of what specific skills are
needed and make them available
Scheduling is determining
who,
by name and skill ,
will do what work and
when (specific time period)

MEANING
Staffing as largely a part of organizing,
establishing the framework within which
the work will get done, while scheduling is
essentially a refined component of
planning.
The concept of good staffing determines
and provides the acceptable number of
personnel to produce a desired level of
care to meet the patients demand of care

MEANING
When the demand of patients needs
increases or decreases in a ward. It is
necessary to reassign nurses to
balance the staff as per needs.
The dynamic staffing and allocation
process is accomplished by taking
staff from one ward to another or by
posting extra nurses on relieving duty.

 Allocation provides information to

adjust the scheduled staff to meet
daily workload demand of each unit.
This component is concerned with
the balancing of staff to fluctuation of
work load among similar nursing
units through personnel allocation
and selective patients placement.

ALLOCATION
Appropriate selection of staff in
the departments according to
their capabilities would help
nurses
to
provide
efficient
nursing care to the patient.

Objectives of Allocation
Procedure
The objectives of allocation procedure is
to reassign working days and days off
to nursing staff so that:
To provide quality patient care
To avoid over staffing or under staffing
in a unit and
To facilitate a desirable distribution of
day off for nursing personnel

Criteria for Effective

Staffing Procedure
An effective allocation procedure meets the
following criteria:
Coverage: the number of nurses assigned
to be on duty should be in relation to the
minimum number of nurses required
Quality: the total number of patient care
should be planned in such a way that
trained nurses are available for patient
care of 24 hours a day. It should also cover
off days on rotation.

Criteria for Effective

Staffing Procedure
Stability: allocation procedure must be
consistent with leave and rotation policy.
Each nurse must know her off, privileged
leave etc.
Flexibility: the allocation policy must
provide for flexibility e.g., if a request for
days off or leave comes as emergency,
that should be taken care of.
Objectives: there should be fairness in
allocation and scheduling shift duties

FACTORS
AFFECTING
ALLOCATION
PROCESS

Allocation procedure
Patients classification system does not
measure the amount of care required by
patients.
However the category of patient fails within the
unit can be correlated with the total amount of
nursing care required by that patient.
The result of patient classification and
measurement of nursing services provided are
combined to obtain the hours and minutes of
direct patient care for each class of patient for
each shift during the period of observation

Allocation procedure
The total minutes or hours of care for any
population of patients in unit can be arriving at
the services required for the given number of
patients. The estimated workload is presented
in terms of the total amount of care required.
A workload sheet is used to calculate the mean
number of nursing hours required in that unit.
Various methods are adopted to classify the
patients and to assess nursing hours needed by
per day by each category of patients.

 Following is an example of nursing

care conducted by college of nursing,
Delhi and T.N.A.I.. Accordingly patients
are classified under 3 categories:
Completely dependent

Partially dependent

Ambulatory

Allocation procedure
Goddards classified the patients
dependency into 5 categories:
Totally ambulant
Partially bed fast
Bed fast but not helpless
Partially helpless
Totally helpless

Another classification
system presented by E.A.
Schmied
A patient who requires only minimal amount of

nursing care (an average of 2.8 nursing hours per

24 hours)
A patient who requires average amount of nursing
care (an average of 4.3 nursing hours per 24 hours)
A patient who requires above average nursing
care (an average of 5.6 nursing hours per 24 hours)
A patient who requires maximum nursing care (an
average of 8.6 nursing hours per 24 hours)

 According to the study conducted in

college of nursing, Delhi, the nursing
hours needed by per category of patient
in 24 hours assessed as given below:
Category of
Patient

Morning
Shift

Evening
Shift

Night Shift

Total

I
Completely
Dependent
II Partially
Dependent

3.27

2.50

1.47

7.24

1.62

0.91

0.55

3.08

III
Ambulatory

1.20

0.70

0.17

2.07

6.09

4.11

2.10

12.29

 Now, we will learn how to allocate nurses in each

unit. Suppose a ward having 30 patients in which
10 patients are ambulatory, 15 patients partially
dependent and 5 patients are completely
dependent.
There are 3 equal hours shift duty and we need
to allocate nurses for 24 hours. We know work
load as well as classification of patients. It is very
simple to calculate. The following table is self
explanatory to the known method of calculation:

Category of
patient

Daily
average
time per
patient in
24 hours
7.24

Total
patient

Calculation
per
category of
patient

Total

7. 24 5

36.20

Completely
dependent
II

3.08

15

3.08 15

46.20

Partially
dependent
III

2.07

10

2.07 10

20.70

Ambulatory
patient
Total work load for 30 patients = 103 hours

103.10 hours

 Each nurse is expected to work

= 8 Hrs/
day
Total number of Nurses required
= 103/8
= 13

= 13 nurses approximately
Provision of day off, Casual leave, Earned
leave and other permitted Gazetted about
116 days/year. To meet leave vacancies
extra nurses required;

= 116/365 103/8

= 4.09 nurses
Total nurses required = 13 + 4 = 17 Nurses.

 When we know the total number of

allocation we must also know to
calculate the number of nurses
required in each shift.
We have already been acquainted with
nursing hours requirement per patient
per category per shift.
We have 30 patients and we have 17
nurses at our disposal. Let us learn the
calculation from the given below:

Category of
patient

Morning shift
nursing hours

Evening shift
nursing hours

Night shift
nursing hours

I 5 completely 3.27 5 = 16.35 2.55=12.50

dependent

1.455=7.25

II 15 Partially
dependent
patients

1.6215 =
24.30

0.56 15= 8.40

III 10
Ambulatory

1.210 = 12.00 0.710 = 7

0.17 10 = 1.70

Total Nursing
units time in
each shift Hrs

52.65

17.35

0.9115 =
13.65

33.15

Total = 103.15 Hours

 Staff requirement in each shift according

to workload in each shift
Staff in morning shift = 52.65
13/103.15= 7
Staff in evening shift = 33.15
13/103.15 = 4
Staff in night shift
= 13 (7+4) = 2
So we have to allocate 7 nurses in
morning shift, 4 in evening and 2 in nigh
shift

HAVE ANY
QUESTION?

CONCLUSION
In the above method we have seen that in
order to allocate nurse in each unit, we
have acquainted with several approaches.
The
first approach is an empirical
approach in which the supervisor or head
nurse requests a certain number of
personnel according to how many nurses
she thinks are necessary to perform the
work in that unit. This approach does not
provide a ratio of professional to nonprofessional persons.

 A second approach is based on the

nursing hours required by each
category of personnel in each shift
in 24 hours. Nursing care hours are
based on total number of patients
in each category. Again no set
standard for nursing hours are
available

 Activity analysis or task analysis

of each person and how long he
does each task is another
approach to allocate nurses. A
work load index is used as an
approach for allocation of nurses
in wards, This is based on a
realistic evaluation of patient
care requirements:

 The ward sisters must send census

report of their unit daily to nurse
administrator along with the types of
patients admitted in their unit. It gives
an idea of census fluctuations, patient
classification problems, in appropriate
staffing in that unit and other variances.
It gives a clue for forecasting need of
nursing personnel monthly and yearly

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THANK YOU