Did the interviewer follow the principles discussed in this chapter?
STAFFING AND SCHEDULING 219
Picard and Warner (2007) suggest fine-tuning PCS systems to predict the demand for nursing expertise several days in advance. They complain that basing staffing on immediate patient needs is short-sighted and often results in failure as mentioned above. Their system, called demand man- agement, uses best-practices staffing protocols to predict and control the demand for nurses based on patient outcomes. Based on historical data, a patient progress pattern typifies expected patient outcomes throughout a stay. Deviations are tracked and staffing adjusted accordingly. This system allows the manager to staff into the next few days with more assurance than predicting from one shift to the next. Whatever system is used, the next step is to determine the necessary nursing care hours.
Determining Nursing Care Hours Patient workload trends are analyzed for each day of the week (each hour in critical care) or for a specific patient diagnosis to determine staffing needs, known as nursing care hours (NCHs). For example, if 26 patients with the following acuities required 161 nursing care hours, then an average of 6.19 nursing hours per patient per day (NHPPD) are required. NHPPD are calculated by divid- ing the total nursing care hours by the total census (number of patients).
There are no specific standards for NCHs for any type of patient or patient care unit. NCHs may vary on the average from five to seven hours of care for patients on medical and/or surgi- cal units, to 10 to 24 hours of care for patients in critical care units, to 24 to 48 hours of care for selected patients, such as new, severely burned patients.