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EMH Nurse Staffing

Nurse Staffing levels are designed to provide that:

  • An RN defines, directs, supervises and evaluates care of all patients.
  • All patients assigned to a non-RN team member are also co-assigned to an RN.
  • Patient care needs are assessed and an appropriate plan of care is developed by an RN.
  • Emergency and safety patient requirements are met.

To insure that staff is assigned appropriately, the following variables are considered when making patient assignments:

  • Complexity of patient's condition and care needs.
  • Dynamics of the patient's status.
  • Type of technology required for care such as chest tubes, ventilators, invasive lines, etc.
  • Complexity of patient assessment.
  • Competency of assigned personnel in relationship to knowledge and skills required to provide care and utilize current technology.
  • Supervisory requirements of the assigned personnel and the availability of such supervision.
  • Relevant infection control and safety issues.

The following is the 2012 staffing plan established for EMH Elyria Medical Center.  It is based on professional and regulatory standards as well as recognized professional benchmark data from the National Database for Nursing Quality Indicators (NDNQI).  NDNQI is a program of the American Nurses Association's (ANA) National Center for Nursing Quality (NCNQ) and is managed by the University of Kansas School of Nursing.  Direct Care Worked Hours (DCWH) are defined as hours that the nurse spends taking direct care of patients.  It does not include administrative duties.

EMH Elyria Medical Center...

Unit Professional/Benchmark Standard Staffing Plan

11 Smythe

Medical
Acute Care for the Elderly (ACE)

National Database for Nursing Quality Indicators (NDNQI)

ANA Principles for Nurse Staffing
  • Total Direct Care Worked Hours (DCWH) 8.2
  • RN DCWH 5.14
  • PCT DCWH 3.06
10 Smythe

NDNQI

ANA Principles for Nurse Staffing
  • Total DCWH 8.2
  • RN DCWH 5.14
  • PCT/LPN DCWH 3.06 + close observation staff not counted in DCWH
9 Smythe

NDNQI

ANA Principles for Nurse Staffing
  • Total DCWH 8.14
  • RN DCWH 5.4
  • PCT DCWH 2.74
8 Smythe

No comparable unit in NDNQI (combined critical care/telemetry)

ANA Principles for Nurse Staffing
  • Critical RN DCWH 13.5 + additional hours for 1:1 heart recovery and fixed nurse tech staffing
  • Telemetry RN DCWH 7.4 + fixed nurse tech
Medical Intensive Care Unit (MICU)

NDNQI 

ANA Principles for Nurse Staffing
  • RN DCWH 13.2 + fixed nurse tech
Surgical Intensive Care Unity (SICU)

NDNQI

ANA Principles for Nurse Staffing
  • RN DCWH 13.2 + fixed nurse tech

 6 Smythe

Orthopedic

NDNQI 

ANA Principles for Nurse Staffing
  • Total DCWH 8.2 
  • RN DCWH 5.14
  • PCT/LPN DCWH 3.06

6 Smythe

Joint Center
 ANA Principles for Nurse Staffing
  • 3 RN;s x 24 hrs. - Monday - Friday
  • 2 RN's x 24 hrs. - Weekend
  • 3 PCT's x 24 hrs. - Monday - Friday
  • 2 PCT's x 24 hrs. - Weekend
5 Smythe

NDNQI

ANA Principles for Nurse Staffing
  • Total DCWH 8.20
  • RN DCWH 5.14
  • PCT/LPN DCWH 3.06
Family Birth Center (FBC)

Ohio Department of Health (ODH)/ Association of Women's Health, Obstetrics and Neonatal Nurses (AWOHNN)

ANA Principles for Nurse Staffing

 Total DCWH/Delivery 41.00
Acute Care for the Elderly (ACE) No comparable unit in NDNQI
  • Total DCWH 9.60
  • RN 4.80
Emergency Care Center (ECC) - includes Elyria, Amherst & Avon

Guidelines for Determining Emergency Department Nurse Staffing (2003)

Emergency Nurses Association (expected revision March 2012 from the ENA)

Fixed RN/Non-RN Personnel required to operate at full capacity

  • Elyria - approximately 35 bed spaces
  • Avon - 13
  • Amherst - 9

Approximately 1 RN per 3-4 bed assignment (at surge)
Clinical Decision Unit (CDU) ANA Principles for Nurse Staffing
  • 1 RN : 5 patients
  • 1 PCTU : 5 aptients
  • Add 1 RN 6-9 patients
Operating Room (OR) Association of Operating Room Nurses (AORN) 1 RN, 1 Tech per OR room; however could be 2 RN's per room if patient is critical
Post Anesthesia Care Unit (PACU) Association of Operating Room Nurses (AORN) 1:1 for first half hour, then 1:2 after, if not critical
Ambulatory Care Center (ACC) American Society of Perianesthesia Nurses (ASPAN) ACC 1:3
Oscopy American Society of Anesthesiologists (ASA) 1 RN for sedation, 1 Tech for instrumentation and 1 RN between rooms. 2.5:1
Radiology The Joint Commission (TJC) standard for invasive procedures and conscious sedation 1 RN invasive procedure, 2 RN for conscious sedation
Heart Cath Lab (HCL) American Society of Perianesthesia Nurses (ASPAN)/ Association of Operating Room Nurses (AORN)

HCL

  • Routine Cases
    • 3-4 staff
    • At least 1 RN
  • Emergent Cases
    • 4 staff
    • At least 2 RNs

EP

  • 2-4 staff based on procedure
  • At least 1 RN for procedure requiring 2 staff (i.e. cardioversions)
5 West  Ohio Department of Mental Health (ODMH) RN on duty at all times.  1 RN for every 4 patients.
Home Health Care  CMS regulations regarding Conditions of Participation for Home Health Agencies 1.8 RN/visit

  
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