| Reason For +/- 5% Variance From Budget |
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No explanation required
No explanation of staffing hours was required if the unit's actual worked hours were within +/- 5% of the 2007 submitted unit staffing plan.
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Fluctuating day to day census
The number of patients on the patient care unit varied significantly from day to day impacting the overall actual staffing hours provided in 2007.
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Lower daily census than planned
The actual average number of patients per day on the unit was less than the planned average patients per day submitted in the displayed 2007 staffing plan.
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Higher daily census than planned
The actual average number of patients per day on the unit was greater than the planned average patients per day in the displayed 2007 staffing plan.
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Higher patient care needs than planned
The average patient required more care than expected and that took more staff than the displayed 2007 staffing plan.
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Lower patient care needs than planned
The average patient required less care than expected and that took less staff than the displayed 2007 staffing plan.
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Staff vacancies
The unit had more job openings than planned and that impacted the average staffing hours on the unit.
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Adjusted for patient care needs
The average actual patient care requirements were different than what was submitted in the 2007 unit staffing plan.
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Minimum fixed staffing requirements
A minimal level of staffing is required on each unit regardless of the number of patients or their care needs. Adjusting to a minimum fixed staffing level increases staffing care hours.
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Care delivery model changes
The way in which direct care staff are assigned to care for patients changed.
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Increased 1:1 staffing requirements
The number of patients on this unit requiring one nurse assigned to one patient was higher than planned.
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Closure of unit
The unit was closed at some point and that impacted overall staffing hours.
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Not admitting to beds due to staffing
Patients were not admitted to the unit because there were lower staffing levels on the unit than planned.
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Increased census to telemetry patients
The number of patients requiring cardiac monitoring was higher than the 2007 staffing plan.
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Plan based on high needs in critical care
The 2007 critical care staffing plan based staffing on high acuity or patient care requirements.
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Increased staff hours to facilitate admissions and discharges
This unit required more staffing than expected because of the number of patients being admitted and discharged from the unit each day.
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Change in patient mix
The actual type of patients admitted on this unit was different from the development of the 2007 staffing plan requirements.
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| Other Reasons for +/- 5% Variance |
| Nursing Education is organized and directed by one nurse educator with support from Nursing leadership. The education plan is defined by identufied issues via monioring and staff survey. Nursing Leadership on all 3 shifts support the education process as well as hospital wide interdisciplinary inservicing and outside speakers.
Periodically throughout the year nursing students have a month rotation providing care on a 1:1 basis but the responsibility remains with the hospital staff and the impact on staff plan is minimal.
"Other " team members refers to:
Wound RN responsible for weekly rounds, assists with plan of care for complex wounds, and chairs the Interdis. Wound Comm.
Pyschology/Neuro - Psych for supportive counselling
Physiatry is available for major wound mgt. and prevention of further complications related to muscle contracture and deminished moblity. |
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| Additional Comments |
| We frequently have patients whose safety awareness is impaired and therefore require 1:1 observation. This observation is provided by trained pt. care attendants titled Rehabilitation Nurtsing Technicians. They are responsible for providing all the unskilled care with RN/LPN providing skilled care. When reviewing the actual staffing vs the buget most often the reason for going above budget is the increased number of unskilled patient care providers. We have found that the use of Rehab Nursing Technicians have reduced our use of restraint as well as our fall with injury rate. |
