Each patient needs a different amount of care according to the Patient Classification Systems (PCS). In the provided example, the nurses are needed for the day shift. There are one RN, one LPN, and one ward clerk present. The nurses work for 8 hours, and the clerk works for 4 hours. Together, they can assist patients for 16 hours of workload, because the ward clerk most likely does not have any duties related to patient care. The shift has to care for the following patients:
- One patient (category I acuity level) – 2.3 hours
- Two patients (category II acuity level) – 2.9*2=5.8 hours
- Three patients (category III acuity level) – 3.4*3=10.2 hours
- One patient (category IV acuity level) – 4.6 hours
- Total – 2.3+5.8+10.2+4.6=22.9 hours
The hours needed to care for these patients are over 6.9 hours (22.9-16=6.9 hours) the nursing workload, which means that the shift is understaffed and needs another nurse to be present.
The second example has different results. By changing the patients’ level of acuity, their needs also become different (Hughes, Bobay, Jolly, & Suby, 2015). Therefore, the workload needs to be recalculated in order to staff the shift properly.
- Two patients (category I acuity level) – 2.3*2=4.6 hours
- Three patients (category II acuity level) – 2.9*3=8.7 hours
- Two patients (category III acuity level) – 3.4*2=6.8 hours
- Zero patients (category IV acuity level) – 0 hours
- Total – 4.6+8.7+6.8+0=20.1 hours
The total hours needed for nurses to care for patients are over 4.1 than their existing workload. Therefore, the shift is still overstaffed, although the difference in less than in the first example. Thus, tone more nurses should still be added to the shift in order to care for all patients adequately.
References
Fanneran, T., Brimblecombe, N., Bradley, E., & Gregory, S. (2015). Using workload measurement tools in diverse care contexts: The experience of staff in mental health and learning disability inpatient settings. Journal of Psychiatric and Mental Health Nursing, 22(10), 764-772.
Hughes, R. G., Bobay, K. L., Jolly, N. A., & Suby, C. (2015). Comparison of nurse staffing based on changes in unit‐level workload associated with patient churn. Journal of Nursing Management, 23(3), 390-400.