Skilled Care and Budgeted Staffing Nursing Worksheet

Skilled Care and Budgeted Staffing Nursing Worksheet

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Skilled Care and Budgeted Staffing Nursing Worksheet

Consider this actual scenario (from my practice). You are a nurse manager of a 24-bed skilled nursing unit in a life-care community. The budgeting staffing is:

Day Shift – 1 RN, 1 LPN, and 4 CNAs

Evening Shift – 1 RN, 1 LPN, and 4 CNAs

Night Shift – 1 RN, 2 CNAs

To achieve your budgeted staffing, your FTEs are as follows (all FT and PT staff work every other weekend):

RN = (3) 1.0 FTE and (3) .4 FTE

LPN = (2) 1.0 FTE and (2) .4 FTE

CNA = (10) 1.0 FTE and (10) .4 FTE

You are able to fill your RN and LPN positions, however, you have difficulty hiring part-time CNAs. You hire students to cover weekends and experience nearly 100% turnover in 3-months. Subsequently, you have to hire agency CNAs at an increased cost and a negative impact on morale.

You learn that most CNAs work 2 full-time jobs to cover their expenses and call out quite frequently on both jobs. This practice increases the use of agency and overtime, and has a terrible effect on resident and staff satisfaction. Though you provide all the staff with a regular schedule at least 4 weeks in advance, the call-out rate for CNAs does not change.

You learn that your organization considers full-time as 60 hours biweekly (versus 80 hours). Employees scheduled (and work) at least 60 hours biweekly receive full benefits including family healthcare and prorated time off based on the number of hours they work up to 80 hours biweekly.

Your goal is to a) meet budgeted staffing goals, b) eliminate agency, and c) implement self-coverage for unplanned absences (staff switch or replace themselves with other staff without incurring overtime). What is your solution?

Patient Assessment & Health History Discussion

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

Case study

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his

daughter, a single mother who has little time or money for her father’s health needs. He

has ahx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12

deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec

20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an

annual exam and states “I came for my annual physical exam, but do not want to be a

burden to my daughter.”

RUBRIC
Excellent Quality 95-100%	Introduction 45-41 points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.		Literature Support 91-84  points The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.			Methodology 58-53 points Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met.
Average Score 50-85%	40-38 points More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided.		83-76  points Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration.			52-49  points Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met.
Poor Quality 0-45%	37-1 points The background and/or significance are missing. No search history information is provided.		75-1 points Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration.			48-1 points There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met
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