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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:..

Solution

Staffing Decisions in a 30- Bed Medical Surgical Unit

Introduction

For several decades, healthcare costs in the US continue to increase, thus posing a significant challenge to stakeholders within the US healthcare system, including the federal, state, and local governments, care providers, and patients. The worrying trend continues to prompt leaders within the healthcare sector to explore measures and strategies that would reduce the cost of care if successfully implemented. As expected, I frequently encounter the requirement to apply prudent financial management principles like planning, organization, and sound decision-making skills to ensure the organization registers improved performance outcomes. To ensure that the efficiency of our medical-surgical unit remains at acceptable levels, I had to develop a strategic staffing matrix to definitively address the perennial issues of high operating costs, nurse fatigue, not to mention the attendant management of the scare hospital resources (Everhart et al., 2013). The staffing matrix also accords the nurses a chance to utilize their decision-making skills to enhance their personal and professional development, even as they improve our unit’s overall performance. Therefore, this essay aims at examining the importance of using a staffing matrix in a selected healthcare setting.

Importance of a Staffing Matrix in One’s Health Care Setting

According to Aiken et al. (2018), there exists a direct connection between nurse staffing levels and a hospital’s mortality rate. Yet, policymakers at the national level and hospital executives usually regard a healthcare organization nurse staffing as an expense that should be contained at all costs hence the importance of a staffing matrix with the medical-surgical unit. Besides the decreased hospital mortality rate that would result from the utilization of a staffing matrix effectively, other benefits include budget management, accountability, and human resource management. 

To start with, the high operation costs encountered in many healthcare facilities would become a thing of the past since a staffing matrix facilitates cost reduction since over- staffing is contained. The matrix ensures that each nurse within a care team is taken into consideration during resource allocation. For example, the average number of full-time nurses in the 30-bed medical-surgical unit is twenty-one. Assuming the team will be compensated at an average of $50 every hour, the unit’s total labor costs will be around $ 12 600. At this point, it is clear that a staffing matrix plays a significant role in the unit’s financial plan that fully covers its operations. The set staffing matrix’s time frame is set at one week to give room for improvement s if discrepancies are noted within the first week. As a result, the matrix envisages a situation whereby the budget can be reduced in the weeks that follow if wastage is determined. Reflections on the average daily cost shed insights into the fact that each budget’s weekly limit enhances flexibility where for example, if the number of patients decreased by say ten, then the number of nursing staff within the unit would also be reduced. To cater to those when the patient numbers significantly increase beyond the anticipated daily average, I personally find it beneficial; to incorporate a nurse labor agency’s services. The nurses hired from the labor agency would operate based on a contractual freelance. Therefore, Suffice says that the budget–based staffing model accords the unit to contain its operating costs without having to lay off any of its nursing staff on the permanent list. Simultaneously, a staffing matrix is essential since it promotes accountability, thus arresting resource mismanagement attributed to the absence of planning. Hampton (2017) opines that effective management of resources calls for strategies that are well documented before, during, and after the implementation.

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Additionally, the documented structural approach to leadership enables the management to keep track of progress in real-time, avoid medication errors, and simultaneously ensure that timelines as a financial principle are observed. Thirdly, a staffing matrix is an efficient tool in the management t of human resources since it lets the Nurse Manager address issues like burnout and understaffing. To effectively address understaffing, the nurse to patient ratio staffing model where Assanye et al. (2020) contends that equilibrium is necessary for the promotion of good quality care that the patients receive.

Description of the Staffing Matrix

       It is essential to observe that after considering a combination of factors. The scheduled daily full-time roaster of 5 registered nurses per day, as outlined in the budget – based staffing model. If and whenever necessary, these RNs will be supplemented with between two and three FTEs each day the patient census exceeds. At this juncture, I remember the motivating factors that made me develop a staffing matrix to improve my managerial skills through effective allocation of resources, whether fiscal or non- fiscal. Some of the financial management principles that I used to determine the completed staffing matrix are that every hospital unit requires adequate financial resources to execute its mandated role in offering quality patient care. The second economic principle clearly states that a budget as a financial tool must project the necessary resources to attain the unit’s goals and objectives. The guide requiring each team has to provide sufficient safeguards to protect against loss or unauthorized use of the hospital’s resources.

How the Nurse Adjusted Their Staffing Based On Changes in the Patient Census

             I applied the average nurse to patient ratio for surgical units to calculate the staffing rations. These ratios leveled off at 1:3 on any given day regardless of the patient census. The maximum FT remained at 5 for the day as well as night shift. On the other hand, the FTE for the night shift had a cap at 2, while the RN to NA ratio was 2:1. The two main financial management principles informed these ratios of organization and critical decision making. Keeping every at a constant, one should appreciate that nurses are leaders in their own rights, meaning every nurse manager should allow their staff members to apply their leadership ship skills by letting them make analytical and creative decisions in offering care to the patients. The simple fact that nurses are in direct care contact with the patients gives them a vantage point where they can define the course of a patient’s treatment throughout the entire duration that their patients are in hospital. Guided by this, I allocated one assistant to two RNS to have the latter concentrate on making analytical decisions while the delegate repetitive roles to their assistants. Again, as a nurse leader in the medical-surgical unit, this gesture is calculated to decrease the operational costs and the costs of operation.

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Staffing decisions in a 30- bed medical surgical unit
Staffing Decisions in a 30- Bed Medical Surgical Unit

Upon Receipt of a Financial Report

`           The staffing matrix flexibility remained a vital component of the completed matrix, and as the patient population continues to change, the number of full-time nurses has a ceiling at 5. Capping the full-time nurses at 5 would prevent the unit from engaging in a spending spree driven mainly due to an unavoidable expenditure through overstaffing. The use of freelancers would secure the numbers of nurses in a care team without compromising service delivery on behalf of the patient or the healthcare organization’s financial security. Working on the premise that the staffing matrix consumed more dollars than those accounted for in the census, it is my responsibility to close the variance by cutting the freelance staff budget. Similarly, the RN to NA ratio could be adjusted either at 3:1 or 4:1. Dagestad & Grassley(2019) report that NAs can handle up to 13 patients. Using this data, the number of NAs in a team could bring the numbers further down. The unit could also use interns and attaches in place of NAs so that any modifications to the staffing matrix do not result in devastating financial difficulties to the nursing team within our unit.

Conclusion

           In conclusion, the staffing matrix means that if the financial outcomes do not register an improvement, the unit’s coordinator will intervene and execute some of the duties. This action is not expected to lead to burnout since the budget will reflect an accurate and fair picture of the low budget, which indicates a low patient census. Financial management experts in the healthcare industry also acknowledge that different units with a healthcare facility have different staffing matrix at their disposal, resulting in varying degrees of accuracy and decreased operating expenses within their organization. 

References

Aiken, L. H., Cerón, C., Simonetti, M., Lake, E. T., Galiano, A., Garbarini, A., … & Smith, H. L. (2018). Hospital nurse staffing and patient outcomes. Revista Médica Clínica Las Condes29(3), 322-327.

Assaye, A. M., Wiechula, R., Schultz, T. J., & Feo, R. (2020). Nurse staffing models in medical‐surgical units of acute care settings: A cross‐sectional study. International Journal of Nursing Practice, 26(1), e12812. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/ijn.12812

Dagestad, A. J., & Grassley, S. (2019). Embracing Change by Moving Forward With an Activity-Based Staffing Matrix. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(3), S73. Retrieved from https://www.jognn.org/article/S0884-2175 (19)30172-8/abstract

Dong, G. N. (2015). Performing well in financial management and quality of care: evidence from hospital process measures to treat cardiovascular disease. BMC Health Services Research15(1), 45.

Everhart, D., Neff, D., Al-Amin, M., Nogle, J., & Weech-Maldonado, R. (2013). The effects of nurse staffing on hospital financial performance: Competitive versus less competitive markets. Health care management review38(2), 146.

Hampton, M. (2017). Maintain optimal staffing with position control. Nursing Management, 48(1), 7-8. Retrieved from https://journals.lww.com/nursingmanagement/FullText/2017/01000/Maintain_optimal_staffing_with_position_control.3.aspx

Question – Staffing Decisions in a 30- Bed Medical Surgical Unit

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:

  1. Why is it important to use a staffing matrix in your health care setting?
  2. 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?
  3. Explain how you adjusted your staffing based on changes in the patient census.
  4. 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.

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Staffing decisions in a 30- bed medical surgical unit
Staffing Decisions in a 30- Bed Medical Surgical Unit

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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