NUR 621 Benchmark – Staffing Matrix and Reflection
NUR 621 Benchmark – Staffing Matrix and Reflection
Staffing Matrix and Reflection Essay
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Every hospital or healthcare institution needs to have an efficient staff management plan to facilitate faster delivery of services and ensure the efficient delivery of services. This essay breaks down the importance of a shift matrix for nurses utilizable by a 30-bed surgical ward.
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Importance of a Shift Matrix in the Healthcare Setting
When a workable shift matrix is in place, the individual nurses can plan their time well. Therefore, it means that one is less likely to suffer fatigue since shift and handing over is done efficiently. One can also relax, rejuvenate, and prepare for the next shift (Taylor, Henshall, Goodwin, & Kenyon, 2018). In the end, there would be reduced incidences of nursing reporting stress and burn out related to long working hours.
A shift matrix helps to save costs related to patient injuries and payrolls. Essentially, an adequate number of nurses per shift allows the hospital unit to keep proper watch over the patients, hence reduced possibility of falls. Staff injuries are also reduced to a great extent since one work while paying full attention. It is unlikely that the hospital or any healthcare setting will suffer lawsuits over negligence or deliberate errors since the nurses do not work under the influence of fatigue or burn out.
A shift matrix presents a suitable skill-mix, which makes it possible to share tasks and reduce workloads. Also, experienced nurses can train and impact nurse assistants in a more meaningful manner. Teamwork and collaboration are therefore cultivated better, ensuring the healthcare setting achieves the set goals and objectives.
When a staffing matrix is efficient, there is usually proper handing over responsibilities from one nurse during one shift to another. In the end, this ensures the delivery of standard care to the patients (Taylor et al., 2018). In the end, there is reduced variation in terms of the outcomes realized by the patients being attended to by the same nurses, keeping other factors constant. NUR 621 Benchmark – Staffing Matrix and Reflection
Explanation of the Shift Matrix
| Census | 30 | 29 | 28 | 27 | 26 | 25 | 24 | ||
| Direct Caregivers | Scheduled Hours | Shift Length | Number of Staff | ||||||
| Day Shift | |||||||||
| RN | 630 | 15 | 12 | 12 | 12 | 12 | 12 | 12 | 12 |
| NA | 630 | 15 | 4 | 4 | 4 | 4 | 4 | 4 | 4 |
| Health Unit Coordinator | 630 | 15 | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
| Night Shift | |||||||||
| RN | 280 | 10 | 8 | 8 | 8 | 8 | 8 | 8 | 8 |
| NA | 280 | 10 | 3 | 3 | 3 | 3 | 3 | 3 | 3 |
| Health Unit Coordinator | 280 | 10 | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
This is a seven-day shift and typical for a 30-bed capacity medical-surgical unit. The total number of RN is 20, 7 NA, and 4 Health Unit coordinators. During the day shift every day, there are 16 nurses on duty while 4 would report for the night shift. Four NAs would be available daily during the day shift and 3 for the night shift. On both day and night shift, there would be 2 health unit coordinators. The day shift is divided into early shift and late shift broken down as indicated in the table below:
| Shift | Hours | RN | RA | Coordinators | Days |
| Early shift (0715-1430 hours) | 7.5 | 8 | 2 | 1 | 7 |
| Late shift (1400-2130 hours) | 7.5 | 8 | 2 | 1 | 7 |
| Night shift (2115-0715 hours) | 7.5 | 4 | 3 | 2 | 7 |
The matrix assumes that there are no sick day-off, and in case of any, there is a plan on the compensation. There is an assumption that there is a time out adjustment to cover for all types of leave. There is also a handover period of 30 minutes in the morning for the night-to morning shift and a 15-minute morning to afternoon hand over.
The number of hours worked by full-time employees is 7.5 hours per day during the day shift. For seven days a week, this sums up to 52.5 hours (7days x7.5hours). The full-time equivalent would be 54,600 for the full-time nurses who are RN (20 nurses x 52.5 hours x 52 weeks a year). For the NA, the FTE is 19,110 (7 NAs x 52.5 hours x 52 weeks). The FTE for the health unit coordinators is 10,920 (4 coordinators x 52.5 hours x 52 weeks). The total FTE is, therefore, 84,630. The annual FTE thus results in 31 FTE (84,630 total hours/7.5hrs per day x 7 days x 52 weeks).
I used the care hours per patient day (CHPPD) to determine the FTE because it is consistent and very comparable to decide on the deployment process and reporting for the inpatient nurses. Other units of measurements like the midnight census are not reliable since it does not account for the differences in the care for each patient (Hughes, Bobay, Jolly, & Suby, 2015). The financial management principles I considered are consistency, timelines, and justification.
Adjustment of Staff Based on Bed Census: NUR 621 Benchmark – Staffing Matrix and Reflection
I used the generic exact analytic approach to determine the number of nurses working in every shift. In this case, there is an effort to determine the precise number of nurses required to be staffed in each change in a manner that guarantees the expected outcome. The outcome is one that is reflected by the nurse to patient ratio in a cost-effective way (Hurst, n.d.). I favored this approach since it connects with the bed census prediction, so there is an alignment of staffing decisions when inpatient planning occurs. There is also an efficient way to coordinate with other departments. This approach avoids the possibility of overstaffing, which could be counterproductive or even harmful to the overall delivery of services by the nurses.
Adjustment When There are Variances in FTE: NUR 621 Benchmark – Staffing Matrix and Reflection
Determining the cause for the variance in FTE is the most crucial step to mitigate future occurrences. It could be related to errors during budgeting, changing business conditions, and unmet expectations. Once the cause is established, there are strategies to eliminate the causes and streamline expenditure with revenue. One approach I would use to make for variance is to create a flexible budget. The flexible budget enables the comprehension of required resources to support the variable demand and allow the business to be more productive. I would calculate this by finding the ratio between the true (actual) and the budgeted value and then applying an adjustment to the previously planned budget.
I would also consider cost containment, which effectively and efficiently generates the revenue needed to maintain the hospital’s productivity. This approach would ensure the services are still delivered at the required quality at the lowest possible cost. I would also create a position control, and this would help determine the exact budget for labor. The tool would also help to create an accurate inventory or the present and future human resource requirements. Further, the tool would also improve the hiring and scheduling practices hence help reduce higher than budgeted FTEs (A Phase 2 Consulting White Paper Optimal Staffing and Scheduling Management, n.d.). In the end, crisis hiring, which in most cases, attracts extra costs would be avoided when the position control tool is used appropriately.
NUR 621 Benchmark – Staffing Matrix and Reflection References
A Phase 2 Consulting White Paper Optimal Staffing and Scheduling Management. (n.d.).
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. https://doi.org/10.1111/jonm.12147
Hurst, K. (n.d.). Selecting and Applying Methods for Estimating the Size and Mix of Nursing Teams A systematic review of the literature commissioned by the Department of Health Selecting and Applying Methods for Estimating the Size and Mix of Nursing Teams Selecting and Applying Methods for Estimating the Size and Mix of Nursing Teams.
Taylor, B., Henshall, C., Goodwin, L., & Kenyon, S. (2018). Task shifting Midwifery Support Workers as the second health worker at a home birth in the UK: A qualitative study. Midwifery, 62, 109–115. https://doi.org/10.1016/j.midw.2018.03.003
NUR 621 Benchmark – Staffing Matrix and Reflection
Assessment Description
The purpose of this assignment is to prepare students to make staffing decisions based on sound financial management principles and compliance guidelines.
Scenario: You are the nurse leader of a 30-bed medical surgical unit and have to account for all staffing, including any discrepancies. Using sound financial management principles, complete the “NUR-621 Topic 8: Staffing Matrix” in the provided Excel template.
After completing the matrix, compose an 1,000-1,250-word reflection answering the following questions:
- Why is it important to use a staffing matrix in your health care setting?
- Briefly describe your staffing matrix. How many FTEs (full-time equivalent) on the staffing roster are required to cover daily needs? What units of services or work measurement did you use and why? What financial management principles did you use to determine your staffing matrix?
- Explain how you adjusted your staffing based on changes in the patient census.
- You receive your financial report for the month. You have used more FTEs than what was budgeted for your census. How will you make up the variance? How would you reallocate resources to make up for the variance and still comply with guidelines?
Include two to four peer-reviewed references in your essay, including the textbook.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MSN Leadership in Health Care Systems
6.4: Apply sound financial management principles to allocate resources within health care organizations.
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Assessment Description
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For this assignment, complete the required “Field Experience Site Information Form” via your student portal. Once you log into your Student Portal, go to My Apps/Edocs/Click here to access all documents pending an e-signature. If you have any questions concerning this form, or if you are unable to view it in your student portal, contact your assigned field experience counselor for assistance.
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