# CASE STUDY: HEALTH PERSONNEL BUDGET

CASE STUDY: HEALTH PERSONNEL BUDGET

What indicators affect patient care? Identify and describe here.

What are nursing sensitive indicators and how do we use the data to improve outcomes? Explain this here.

Discuss the relationship between nurse staffing and two of the following: urinary tract infections, pneumonia, upper gastrointestinal bleeding, shock, or length of stay.

Part B

There are two calculations in the assignment and that is the FTE and HPPD calculations. To do this, you would take the total care hours: 96,360 (this number is found in the assignment directions) and divide by 2080 (this number comes from taking 40 hours per week X 52 weeks per year). Explain, in a brief paragraph, how you calculated the number of full-time equivalents (FTEs) that would be needed. Provide the calculation. (Be sure to submit this paper and the spreadsheet to the assignment drop box.

Explain HPPD. To calculate the direct care hours per resident/day: Add the total number of direct care nursing staff hours for each 24 hour period, using the actual number of hours each person worked. Divide the total hours for each 24 hour period by the total census for each day to calculate the HPPD. How would the acuity of the unit affect HPPD?

Explain how diagnosis related groups (DRG’s) and Case Mix Index (CMI) affects hours per patient day.

Review the staffing plan for last year. What outcomes would you use to evaluate this staffing plan? Based on this data, would you recommend any changes for the upcoming year?

References

Knickman, J. R. & Kovner, A. R. (2015). Jonas and Kovner’s health care delivery in the United States (11th ed.). New York, NY: Springer Publishing Company.

If you decide to use the APA formatted template provided below, please make sure you perform the following:

GENERAL GUIDELINES

1. Remove all directions as you answer each of the questions found within the template.

2. Be sure that you provide an in-text citation for all sources used.

3. Please be sure to use at least two sources to support the information provided in this analysis report.

4. Be sure that you provide a complete reference page that correlates with all sources that are used in the text.

5. Please adhere to APA guidelines for the written paper component of this assignment.

6. Please be sure to upload the completed Excel worksheet and the written paper to the assignment dropbox.

Complete the Cover Page

Part A:

Guidance:

Craft four paragraphs to discuss:

1. Identify the nursing-sensitive indicators Mary Jane should consider in making staffing decisions.

2. Discuss how nursing-sensitive indicator data can be utilized to enhance the safety and quality of patient care.

3. Discuss the relationship between nurse staffing and two of the following: urinary tract infections, pneumonia, upper gastrointestinal bleeding, shock, or length of stay.

Part B:

Guidance:

Use the data found on the Excel spreadsheet:

Mary Jane has been asked by the Chief Nursing Officer to prepare a personnel budget for the coming fiscal year. Mary Jane has collected the following information, in addition to what she has determined, based on nursing-sensitive indicator data discussed in Part A.

Patient Data Average Daily Census 28 Unit Capacity 30 Average HPPD 8.8  Total Care Hours 96,360 Staff Data Total Hours/employee/year 2,080 Average Salary per Employee Category RN \$36.00/hour LPN \$22.00/hour Nurse’s Aide \$12.00/hour

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Paragraph 1

1. Calculate the number of full-time equivalents (FTEs) that would be needed. Show your calculations.

Guidance:

Paragraph 2

2. Explain HPPD.

Guidance:

Calculating the direct care nursing staff hours within a 24-hour period is essential for administration (managers, directors) when reviewing productivity, forecasting staffing needs, and evaluation of nursing shortage.

To calculate the direct care hours per resident/day: Add the total number of direct care nursing staff hours for each 24 hour period, using the actual number of hours each person worked. Divide the total hours for each 24 hour period by the total census for each day to calculate the HPPD (also referred to as PPD) (Pennsylvania Department of Health, 2016)

a. How would the acuity of the unit affect HPPD?

Paragraph 3

3. Explain how diagnosis related groups (DRG’s) and Case Mix Index (CMI) affects hours per patient day.

Guidance:

What this means is that when staffing a unit, a manager must evaluate the severity of illness, prognoses of patients’ conditions, the difficulty in providing treatment, and the resources needed. For this part of the paper, you will need to: 1) explain what a DRG is and what the CMI is (first two sentences or so), and 2) explain how the varied DRGS (or acuity levels) might impact the hours per patient day. Think of it this way, picture yourself as a nurse manager and think about the resources (staff, equipment, providing total care for a patient who cannot care for the self, etc.) needed to care for a varied mix of patients (low to high acuity). How do you think the varied acuity levels would affect your use of the resources?

Paragraph 4

4. Review the staffing plan for last year. What outcomes would you use to evaluate this staffing plan? Based on this data, would you recommend any changes for the upcoming year?

Guidance: Review the staffing plan for last year. What outcomes would you use to evaluate this staffing plan? Based on this data, would you recommend any changes for the upcoming year? – For this question, think of different issues that might have occurred within a previous work year such as the most common nursing sensitive care measures identified by the National Quality Forum Report (2004): 1. Death among surgical inpatients with treatable serious complications (failure to rescue) 2. Pressure ulcer prevalence 3. Falls prevalence 4. Falls with injury 5. Restraint prevalence (vest and limb only) 6. Urinary catheter-associated urinary tract infection for intensive care unit (ICU) patients** 7. Central line catheter-associated blood stream infection rate for ICU and high-risk nursery (HRN) patients 8. Ventilator-associated pneumonia for ICU Think about the patient ratio on this unit (use the spreadsheet). – How would one plan staffing based on caring for patients with varied acuity levels. – What outcomes would you use to evaluate this staffing plan? (Hint: the outcomes related to the nursing sensitive indicators.) – Based on this data, would you recommend any changes for the upcoming year? If so, how would added resources used to treat patients on varied levels of acuity help?