Personnel Budget Case Study

Budget Staffing Plan Mercy Hospital Center 1 West
Budgeted volume 10,220 Annual census
Adc 28.00 budgeted average daily census
Average daily census 28
Direct Day Eve N
RN 7 6 5
Charge RN/Resource 1 1 1
LPN 2 2 2
NA/PCT 1 1 1
Unit Clerk 1 0 0
House Supervisor 0 0.15 0.15
Department Manager 1 0 0
Total persons per shift 13.00 10.15 9.15
Total prod hrs per day 104.00 81.20 73.20 258.40
Total prod hrs per year 94,316.00
Variables not accounted for
Annual Personnel Budget excluding variables
Position Hourly PayStaff/24 hrs Cost per Year
RN $36.00 18 $1,892,160.00
Charge RN/Resource $37.00 3 $324,120.00
LPN $22.00 6 $385,440.00
NA/PCT $12.00 3 $105,120.00
Subtotal of Direct Care Costs $2,706,840.00
Unit Clerk $10.00 1 $29,200.00
House Supervisor $38.00 0.3 $33,288.00
Department Manager $40.00 1 $83,200.00
Subtotal of Indirect Care Costs $145,688.00
Aggregate Total Direct &
Indirect Personnel Costs $2,852,528.00
Average Personnel Costs per
Part A

Craft four paragraphs to discuss:
Identify the nursing-sensitive indicators Mary Jane should consider in making staffing decisions.
Discuss how nursing-sensitive indicator data can be utilized to enhance the safety and quality of patient care.
Discuss the relationship between nurse staffing and two of the following: urinary tract infections, pneumonia, upper gastrointestinal bleeding, shock, or length of stay.
Part B

Use the data found on the Personnel Budget Case Study (Budget Staffing Plan) PDF:
Mary Jane has been asked by the Chief Nursing Officer to prepare a personnel budget for the coming fiscal year. Mary Jane has collected the following information, in addition to what she has determined, based on nursing-sensitive indicator data discussed in Part A.
Patient Data
Average Daily Census 28
Unit Capacity 30
Average HPPD 8.8
Total Care Hours 96,360
Staff Data
Total Hours/employee/year 2,080
Average Salary per Employee Category
RN $36.00/hour
LPN $22.00/hour
Nurse’s Aide $12.00/hour
Paragraph 1
Calculate the number of full-time equivalents (FTEs) that would be needed. Show your calculations.
Describe your calculations and identify your result.
Paragraph 2
Explain HPPD.
Define what it is and how would the acuity of the unit affect HPPD?
Paragraph 3
Explain how diagnosis related groups (DRG’s) and case mix index (CMI) affects hours per patient day.
What this means is that when staffing a unit, a manager must evaluate the severity of illness, prognoses of patients’ conditions, the difficulty in providing treatment, and the resources needed. For this part of the paper, you will need to: 1) explain what a DRG is and what the CMI is (first two sentences or so), and 2) explain how the varied DRGS (or acuity levels) might impact the hours per patient day. Think of it this way, picture yourself as a nurse manager and think about the resources (staff, equipment, providing total care for a patient who cannot care for the self, etc.) needed to care for a varied mix of patients (low to high acuity). How do you think the varied acuity levels would affect your use of the resources?
Paragraph 4
Review the staffing plan for last year. What outcomes would you use to evaluate this staffing plan? Based on this data, would you recommend any changes for the upcoming year?
For this question, think of different issues that might have occurred within a previous work year such as the most common nursing sensitive care measures identified by the National Quality Forum Report (2004):
Death among surgical inpatients with treatable serious complications (failure to rescue).
Pressure ulcer prevalence.
Falls prevalence.
Falls with injury.
Restraint prevalence (vest and limb only).
Urinary catheter-associated urinary tract infection for intensive care unit (ICU) patients.
Central line catheter-associated blood stream infection rate for ICU and high-risk nursery (HRN) patients.
Ventilator-associated pneumonia for ICU.
Think about the patient ratio on this unit (use the spreadsheet).
How would one plan staffing based on caring for patients with varied acuity levels?
What outcomes would you use to evaluate this staffing plan? (Hint: the outcomes related to the nursing sensitive indicators.)
Based on this data, would you recommend any changes for the upcoming year? If so, how would added resources used to treat patients on varied levels of acuity help?
Provide a reference page. Be sure to refer to the APA guidelines when providing sources.

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