006 or Staffing Plan

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Nursing DepartmentOPERATION THEATER

Staffing Plan

Original Issue Date: June 2011Effective Date: July 2011Due for Revision on: July 2013Number of Pages: 1 of 8

1.0 Title:Scheduling and Staffing Plan for the Operating Room

2.0 Conditions:Applies to all nursing and ancillary staff assigned to work in the OperationRoom Department.

3.0 Purpose:3.1 To provide each nursing unit in the Operating Room with an

appropriate number of the right types of workers to perform the nursingtasks required to give care and comfort to patients in that unit.

3.2 To provide sufficient staff to permit a nurse patient ratio in every criticalcare unit on each shift.

3.3 To involve the Unit Nurse Supervisor and the Director of Nursing, HeadNurse, Staff Nurse, Midwives and other relevant groups, in theconstruction of the overall staffing plan of the unit.

3.4 To assign the Head Nurse of each unit to translate the master staffing planincluding vacation plan / schedule for the personnel assigned in her unit.

4.0 Definitions:4.1 Staffing is a complex function, consisting of sequence of interdependent

steps.

4.2 Methods of Assigning Personnel:


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4.2.1 Functional Method or Task Allocation for Assigning Personnel consist of separating nurse tasks and assigning each nursing staffmember to perform one or two care functions for all patients in aunit or for a large number of patients in the unit.

4.2.2 Team Method for Assigning Personnel a method of assignmentintended to combine professional, technical and ancillary nursingpersonnel into small groups to provide total care to a selectedgroup of patients. One of the registered nurse is appointed by thehead nurse to be the leader of the team.

4.2.3 Patient Allocation this is a system in which each nurse isdelegated responsible for the care of a specific group of patients orjust one patient, as in intensive care or labor ward setting. This kindof allocation may be for the duration of one shift only, or nursesmay work with the same patients whenever they are on duty, overa period of days or weeks.

4.2.4 Primary Method works best in an organization with an allregistered nurse staff. In this method each nurse is given overall

responsibility for planning, executing and evaluating the nursingcare for a small case load of four to five patients.

5.0 Procedure:

5.1 Nursing man power planning should have a systematic and scientificapproach to determine the number of staff required to give care to aspecified group of patients for an acceptable standards.

5.2 The actual number of nurse for a particular unit per hour is determined bythe professional judgment. Then this number is converted into the WholeTime Equivalent by using the Teleford Method as a formula:

Number of Nurses x Working Hours per Day x 7 Days (1 week)

Total Working Hours per Week (51 hours per week)


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Example:

Surgery Department (Main):

25 x 8.5 hours x 7 days------------------------------- =29 FTE51 hours per week

Surgery Department (OB-OR):

11 x 8.5 x 7 days

------------------------- = 13 FTE51 hours per week

Anesthesia Department:

11 x 8.5 x 7 days------------------------- = 13 FTE51 hours per week

Recovery Room/Post Anesthesia Care Unit:

10 x 8.5 x 7days------------------------ = 12 FTE51 hours per week

In addition to this, a 23% should be added to this number to makeprovision for vacations, sick leaves, public holidays, emergency leave, etc.

Therefore the annual requirement for this particular unit will be:

Surgery Department (Main):29 + 23% = 36

Surgery Department (OB-OR):13 + 23% = 16


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Anesthesia Department:

13 + 23% = 16

Recovery Room/Post Anesthesia Care Unit:

12 + 23% = 15

In conclusion, to keep 25 nurses on duty at any one time, it requires 36nurses for surgery then 16 for anesthesia and 15 for PACU.

5.3 This ratio takes consideration of vacation, public holidays (e.g. Ramadanand Hajj Holidays), sick and emergency leaves, etc. According to this

ratio, the total number of nurses required for a particular hospital willsimply be determined by the number of beds, volume and acuity in theunit.

5.4 Staff working at 8 and a half hour shift (or 8 hours and 30 minutes perday) are expected to work at 51 hours per week. Each shift includes one 30minutes break and each staff should have one meal break at 30 minutes.

5.3.1 Split Duty: starts from 0800H 1230H then 1600H 2000H

5.3.2 Straight Duty: from 0800H to 1630H

5.5 The Weekly Schedule consists of 8 and half hours shifts from Saturday toThursday, with one day off duty (Friday) accordingly. e.g. 0800H 12:30Hthen 1600H 2000H

5.6 There are four methods of assigning personnel, before they can specifythe details of the overall staffing program for the department:

5.5.1 Functional Method or Task Allocation (for Anesthesia Nurses)

5.5.2 Team Method (for PACU and Surgery Nurses)

5.5.3 Patient Allocation

5.5.4 Primary Method


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5.7 It is the Head Nurse / Acting Head Nurse or In-Charge Nurse responsibleto calculate and ensure that each employee works the correct number ofhours per schedule. Hours and tour of duty are arranged to providequality nursing care needs of patients take priority when scheduling staff.

5.8 On-Call duty will be covered from 2000H to 0800H for the regular daysand 0800H 2000H and 2000H 0800H for Fridays (Day and Night On-Call Duties) from the different units (Anesthesia, Surgical and PACU) andwill be staying at the OB OR in case there will be an emergency or urgentprocedure to be done. The Head Nurse will determine whether the On-Call Nurses will go for Reverse Duty (from 1600H 2000H) or Straight

Duty (0800H 1300H) on the next day after their On-Call Duty dependingon the number of booked cases. In the event that there will be more thanone case ongoing for the on-call time, a scheduled second and third on-callduty nurses may be asked to go on duty and will then be considered as atime-back as per policy. Each staff will have five on-call duties in a monthto cover 20 hours blanket overtime.

5.9 During Ramadan, duty hours will be changed according to the approvedhospital scheduled hours.

5.10 Weekend Coverage: Weekend is defined as Friday.

5.11 Orientation: It is necessary for newly hired employees to attend thehospital and general nurse orientation according to hospital policy. Theunit orientation should be adjusted at the Head Nurses discretion ofcertain employees, i.e. rehires, transfer, etc.

5.12 Vacant Master Schedule Positions: The Head Nurse may change anemployees master schedule to meet unit needs. When a position is vacant,an employee may request in writing to change. This will be approved

according to unit needs and seniority.

5.13 Schedule Posting: The Head Nurse prepares, prints and posts a draftschedule for staff to review and to request changes (i.e. 2 weeks) prior tothe schedule being finalized.

5.14 Final Schedule: All changes will be made by the Head Nurse / ChargeNurse and a final schedule generated for posting and a copy sent to the


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Nursing Office and the Nursing Supervisor.

5.15 Schedule Changes: Staffs are requested to minimize changes after theschedule is finalized. Request for schedule changes will be considered bythe Head Nurse on an individual basis. Except in emergency situations,the staff nurse is expected to find another nurse of equal qualifications tocover the shift.

5.16 Exchange of Duty: Staffs will need to fill up the Exchange of Duty formthen will be signed by the Head Nurse and the Supervisor at least one dayprior to the said exchange duty dates.

5.17 Staff Vacation Planner: Name of all staff, ID Number and their contractdate will be written in the yearly vacation planner. The proposed schedulevacation leave will be marked x according to the number of weeks andthe vacation leave will only be approved according to the contract date ofthe staff. Any emergency leave filed by a staff within their contract periodwill be approved depending on the department heads discretion andvalid reason.

5.18 Staffing Study: Should gather data about environmental factors within

and outside the organization that affects staffing requirement. Threecardinal rules for forecasting staff requirement:

5.18.1 To base the staffing projections upon past staffing history.5.18.2 To review current staffing levels.5.18.3 To review the future plans for the institution.

5.19 When a Head Nurse initiates a schedule change to balance the schedule,rescheduled rest/work shift must be scheduled and indicated at the time ashift is rescheduled.

5.20 Planning for staffing require judgment, experience and thoroughknowledge of the requirements of the unit.

5.21 Staffing plans are also influenced by institutional missions and objectivesrelated to research, training and other specialties; by the number andcomposition of the medical staff and the medical services offered andarrangement of the physical structure of the institution.


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5.22 Productivity: is defined as output divided by input:

Required staff hours----------------------------- x 100 = ProductivityProvided staff hours

Productivity in nursing is related both to how efficiently clinical nursesdeliver care and how effective that care is relative to its quality andappropriateness.

6.0 Attachment:

6.1 Operation Theater (Anesthesia, Surgical and PACU) Master Schedule

6.2 Exchange of Duty Form

6.3 Daily / Weekly / Monthly Unit Assignment Form

6.4 Yearly Vacation Plan Form

7.0 References:

7.1 OR Policy and Procedure AHH-NUR-OR 002, November 2004

8.0 Approval Section:

Prepared by :

__________________________________ ______________Ms. Bella M. Samonte Date

Clinical Quality Assurance Manager

__________________________________ ______________Ms. Jasmin Aeryll T. Lapnawan DateDepartment Quality Coordinator(OR PACU Nurse)


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Reviewed by :

__________________________________ ______________Ms. Pacita C. Frias Date

Nursing Department Head

__________________________________ ______________Dr. Abdulaziz Dorra Date

Head of the Surgery Department

__________________________________ ______________Dr. Mohammad Askar DateChief of Anesthesia/Head of Operating Room

Approved by :

__________________________________ ______________

Dr. Abdulaziz Al Hammadi DateVice Director of Medical Affairs

__________________________________ ______________Dr. Reema Al Hammadi DateDirector of Medical Affairs

__________________________________ ______________Mr. Mohammad Al Hammadi Date

Executive Director

Documents

006 or Staffing Plan