| Date of Services Reported: FY 2006  | 
                    | 
                  Average Number of Patients Per Day:  | 
                  
                       6.3  | 
                    
               
               
              
                
                  |   | 
                    | 
                    | 
                  Number of Staff  | 
                 
                
                  | Direct Caregivers  | 
                  Scheduled Hours  | 
                  Shift Length | 
                  Mon | 
                  Tues | 
                  Wed | 
                  Thurs | 
                  Fri | 
                  Sat | 
                  Sun | 
                 
                
                  |   | 
                  Day Shift  | 
                 
                
                    
                      | RN  | 
                      
                        7am-3pm | 
                        8.0 | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                     
                  
                    
                      | Unlicensed Assistive Personnel  | 
                      
                        7am-3pm | 
                        8.0 | 
                         1.0  | 
                         1.0  | 
                         1.0  | 
                         1.0  | 
                         1.0  | 
                      
                           
                           | 
                      
                           
                           | 
                     
                  
                
                  |   | 
                    | 
                    | 
                    | 
                    | 
                    | 
                    | 
                    | 
                    | 
                    | 
                 
                
                  |   | 
                 
                
                  |   | 
                  Evening
                    Shift  | 
                 
                
                    
                      | RN  | 
                      
                        3pm-11pm | 
                        8.0 | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                     
                  
                    
                      | Unlicensed Assistive Personnel  | 
                      
                        3pm-11pm | 
                        8.0 | 
                         1.0  | 
                         1.0  | 
                         1.0  | 
                         1.0  | 
                         1.0  | 
                      
                           
                           | 
                      
                           
                           | 
                     
                  
                
                  |   | 
                    | 
                    | 
                    | 
                    | 
                    | 
                    | 
                    | 
                    | 
                    | 
                 
                
                  |   | 
                 
                
                  |   | 
                  Night
                    Shift  | 
                 
                
                    
                      | RN  | 
                      
                        11pm-7am | 
                        8.0 | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                         4.0  | 
                     
                  
                
                  |   | 
                    | 
                    | 
                    | 
                    | 
                    | 
                    | 
                    | 
                    | 
                    | 
                 
               
               
              
                
                  |   | 
                    | 
                  Plan / Budgeted Direct WHPPD 
                    (Worked Hours Per Patient Day)  | 
                  
                      16.93  | 
                    
                
                  |   | 
                    | 
                  Actual Worked Hours Per Patient Day | 
                  
                      17.14  | 
                    
                
                  |   | 
                    | 
                  % Difference | 
                  
                       1.24  | 
                    
                
                     
                  
               
               
              
                
                  
                      
                        | Additional Care Team Members | 
                       
                      
                        | Click here for Care Team Member definitions | 
                       
                      
                        | Skills | 
                        Shift Coverage | 
                       
                      
                        |   | 
                        Day | 
                        Evening | 
                        Night | 
                       
                      
                          
                            | Unit Nurse Management  | 
                            
                                x
                               | 
                            
                                x
                               | 
                            
                                x
                               | 
                           
                          
                          
                            | Staff Educator | 
                            
                                x
                               | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                           
                          
                          
                            | Clinical Nurse Specialist | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                           
                          
                          
                            | Unit Clerical Support | 
                            
                                x
                               | 
                            
                                x
                               | 
                            
                                 
                                 | 
                           
                          
                          
                            | 1:1 Patient Observer | 
                            
                                x
                               | 
                            
                                x
                               | 
                            
                                x
                               | 
                           
                          
                          
                            | Admissions Nurse | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                           
                          
                          
                            | Patient Transport Team  | 
                            
                                x
                               | 
                            
                                x
                               | 
                            
                                 
                                 | 
                           
                          
                          
                            | IV Therapy Team / Line Access | 
                            
                                x
                               | 
                            
                                x
                               | 
                            
                                 
                                 | 
                           
                          
                          
                            | Monitor Technician | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                           
                          
                          
                            | Rapid Response Team  | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                           
                          
                          
                            | Respiratory Therapy Support | 
                            
                                x
                               | 
                            
                                x
                               | 
                            
                                x
                               | 
                           
                          
                          
                            | Nutritionist | 
                            
                                x
                               | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                           
                          
                          
                            | Rehab Activities (OT, PT, Speech) | 
                            
                                x
                               | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                           
                          
                          
                            | Clinical Pharmacist | 
                            
                                x
                               | 
                            
                                x
                               | 
                            
                                x
                               | 
                           
                          
                          
                            | Licensed Social Services / Case Management | 
                            
                                x
                               | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                           
                          
                          
                            | Spiritual Services | 
                            
                                x
                               | 
                            
                                x
                               | 
                            
                                x
                               | 
                           
                          
                          
                            | Hospitalist / NP / PA | 
                            
                                x
                               | 
                            
                                x
                               | 
                            
                                x
                               | 
                           
                          
                          
                            | Intensivist / Neonatologist | 
                            
                                x
                               | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                           
                          
                          
                            | Nursing Student  | 
                            
                                x
                               | 
                            
                                x
                               | 
                            
                                 
                                 | 
                           
                          
                          
                            | Recreation / Milieu Therapist | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                            
                                 
                                 | 
                           
                          
                          
                            | Intern / Resident | 
                            
                                x
                               | 
                            
                                x
                               | 
                            
                                x
                               | 
                           
                          
                          
                            | Off-shift Nursing Supervisor | 
                            
                                 
                                 | 
                            
                                x
                               | 
                            
                                x
                               | 
                           
                        
                      
                          The list of caregivers in these boxes were provided to all hospitals. | 
                       
                      
                          Individual hospitals added the types of caregivers shown in these boxes. | 
                       
                      | 
                  
                      
                        | Additional Unit Information: | 
                       
                      
                        
                          |  Unlicensed Assistive Personnel perform EKG/phlebotomy  | 
                         
                      
                        
                          |  tasks  | 
                         
                      
                        
                          |  Nurse management has 24 hour responsibility for unit.  | 
                         
                      
                      
                        |   | 
                       
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