I’m working on a health & medical discussion question and need the explanation and answer to help me learn.
Case Scenario:
The nurse manager of a medical–surgical unit has a budgeted ADC of 20. A new vascular surgeon has been admitting patients to the unit, which is requiring an increase in nursing care to treat these additional patients. The current budgeted HPPD is 7.59. You have been monitoring the number of patients with the higher acuity in anticipation of budget planning.
You have been reviewing reports, and over the past 6 months since the surgeon came on board you notice an unfavorable salary variance. You also have been tracking the actual census, and the ADC on average remains at 20; however, six of the patients have higher acuity. You are proposing the configuration of the unit is changing to a blended model with an overall ADC of 20. The blend is 70% medical–surgical (ADC and 30% stepdown (6 ADC).
Answer the following Questions below:
You need to discuss the issues with the nurse leader you report to.
1. What discussion points should you plan to cover? Will there be a need for additional FTE caregivers to care for the change in acuity? If so, how many FTEs? Have you been staffing above the staffing guideline using OT?
2. The assumption is you are using OT to cover the additional clinical requirements. Financial reports indicate for the 6-month period OT expense is $125,000, which is unfavorable to the budget. What are your recommendations? Compare the cost of OT used over the past 6 months with the cost of hiring the additional RNs.
3. Develop a revised staffing grid. (very basic does not need to be complex)
Expert Solution Preview
Introduction:
As the nurse manager of a medical-surgical unit, you have observed an increase in nursing care due to the admission of patients by a new vascular surgeon. This increase in patient volume and acuity has led to an unfavorable salary variance and the need for budget planning. In order to address these issues, you need to discuss certain points with the nurse leader you report to, make recommendations regarding the use of overtime (OT) and hiring additional RNs, and develop a revised staffing grid.
1. Discussion points to plan:
– The impact of the new vascular surgeon on the unit’s patient volume and acuity
– The need for additional FTE (full-time equivalent) caregivers to manage the change in acuity
– Calculation of the required number of FTEs based on the new blended model with 70% medical-surgical and 30% stepdown patients
– Evaluation of whether the unit has been staffing above the staffing guideline using OT
Considering the increase in patient acuity and the new blended model of patient distribution, it is likely that the unit will require additional FTE caregivers. To determine the exact number of FTEs needed, a thorough assessment should be conducted, taking into account the anticipated workload, patient acuity, and nursing care requirements. This calculation will help to ensure that adequate staffing levels are maintained to provide safe and quality patient care.
If the unit has been staffing above the staffing guideline using OT, it is essential to evaluate the reasons behind this decision. It could be due to the increased patient volume or the complexity of care required. Assessing the efficiency and cost-effectiveness of using OT in comparison to hiring additional RNs is crucial for making informed decisions and optimizing resource allocation.
2. Recommendations regarding OT and hiring additional RNs:
Based on the financial reports indicating an unfavorable OT expense of $125,000 over the past 6 months, it is necessary to consider alternative strategies. Comparing the cost of OT used with the cost of hiring additional RNs will help determine the best course of action.
If the cost of OT is significantly higher than the cost of hiring additional RNs, it may be more financially advantageous to invest in hiring new staff. Hiring additional RNs can provide long-term benefits, such as improved staffing stability and reduced reliance on OT, which could positively impact both financial and patient care outcomes.
3. Development of a revised staffing grid:
A revised staffing grid needs to be developed to ensure adequate and appropriate staffing levels. While the grid should be tailored to the specific needs of the medical-surgical unit, some basic considerations include:
– Anticipated ADC and patient distribution (e.g., 70% medical-surgical and 30% stepdown)
– Patient acuity levels and the corresponding nurse-to-patient ratios
– Required skill mix and staff competencies
– Absence or leave coverage
The revised staffing grid should align with the demands of the patient population, optimize resource allocation, and prioritize patient safety and quality care delivery.
Conclusion:
Addressing the issues associated with the increase in patient acuity, unfavorable salary variance, and the need for budget planning requires effective communication with the nurse leader, careful evaluation of staffing requirements, and informed decision-making regarding the use of OT and hiring additional RNs. Developing a revised staffing grid that aligns with the changing patient population and nursing care needs will contribute to efficient resource utilization and ultimately improve patient outcomes.
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