| 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 2008 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 2008.
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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 2008 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 2008 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 2008 staffing plan.
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X |
Lower patient care needs than planned
The average patient required less care than expected and that took less staff than the displayed 2008 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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X |
Adjusted for patient care needs
The average actual patient care requirements were different than what was submitted in the 2008 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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X |
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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X |
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 2008 staffing plan.
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Plan based on high needs in critical care
The 2008 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 2006 staffing plan requirements.
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X |
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| Other Reasons for +/- 5% Variance |
| Unable to carve out orientation/preceptor hours, council work, transporting patients, response to emergency calls (e.g. Code Blue, Dr. Stat & RRT)
Unable to care out class time (e.g. ACLS, behavioral crisis training, restraint training)
QA and other Performance Improvement initiatives are performed by staff during their clinical work hours
MedHost implemented in 2008 - all licensed staff education/training hours are represented as actual worked hours
Staff do EKG's after hours after hours and respiratory therapy treatments when therapist busy
Response to critical care emergencies hospital-wide and Dr. Armstrong - Code Blue, stroke team, RRT
ANM has 4 hours of administrative time weekly (included in worked hours)
Staff coverage for open positions (96 hours), orientation of new staff, staff FMLA and Workman's Comp case are reflected as increase in actual worked hours
New monitoring system implemented in 2008 and required orientation is reflected as actual worked hours
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| Additional Comments |
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