Professional Documents
Culture Documents
on
Staffing in 800 Bedded Hospital
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Introduction
Staffing:
WHO defines the nursing services as the part of the total health
organization, which aims to satisfy the nursing needs of the community.
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- The service required
- Procedures/ techniques required for care
- Number and type of personnel needed to perform care effectively
- Physical facilities
- Provision of equipment and supplies
S.I.U Norms Recommended for Nursing Service
- One CNO for 500 or more beds
- One Nursing Supdt. For 250- 500 beds
- One DNS for 7.5 ANS
- One ANS for 4.5 Nursing sisters
- One Nursing Sister for 3.6 Staff Nurses
Placement of Nursing Staff in Each Shift
- Normal Wards : 1: 6 beds + 30% leave reserve
- Special Wards : 1:4 beds+ 30% leave reserve
- ICU : 1: 1 bed + 30 % leave reserve
- Nursery : 1: 2 beds + 30% leave reserve
- Labor room : 1 staff nurse per every bed or table + 30%
leave reserve
- OT (major) : 2 staff nurses / functional operating table+ 30%
leave reserve
- OT (minor) : 1 staff nurse / functional table + 30% leave reserve
- Casualty& emergency: 1:4 beds & 1 nursing sister + 30% leave
reserve
- OPD (100pts/day): 1 staff nurse / shift + 30% leave reserve
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Staffing in 800 Bedded Hospital
Distribution of Beds
Department No of Beds
1. Normal Wards 300
Medical Ward 150
Medicine Ward A 50
Medicine Ward B 50
Medicine Ward C 50
Surgical Ward 150
Surgical Ward A 50
Surgical Ward B 50
Surgical Ward C 50
2. Special Wards 400
Cardiology and Cardiosurgery 60
Neurology and Neurosurgery 60
Oncology and Oncosurgery 40
Nephrology and Nephrosurgery 40
Pediatric Ward 50
Maternity Ward Gynae Ward 50
Orthopedic Ward 20
Eye Ward 30
ENT Ward 30
Dental Ward 20
3. Emergency and Causality 40
4. ICUs (Neuro, Cardio and Main ICU) 50
5. Nursery 10
6. Major OTs (Neuro, Cardio and Main OT) 25 Tables
7. Minor OT 5 Tables
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8. Labour Rooms 10 Tables
9. OPD Expected 1000 Patients/Day
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Distribution of Staff in Various Departments
Emergency and Causality (40 beds)
Bed capacity of causality and emergency is 40; staff requirement
according to SIU Norms is 1:4/ shift i.e.30 staff/day. So, total Staff
Nurses required are 30 + 30% Leave reserve = 39.
Staff Nurses – 39
Nursing Sister – 11(1/ 3.6 staff nurses)
ANS – 2 (1/ 4.5 Nursing Sister)
Normal Wards (Medical + Surgical Ward) - 300 Beds
Staff requirement according to SIU norms is 1:6/ shift i.e. 150 Staff
Nurses/ day. So, total Staff Nurses required are 150 + 30% Leave reserve,
150+45 = 195
Staff Nurses – 195
Nursing Sister – 55
ANS – 12
DNS - 2
Special Wards (400 Beds)
Staff requirement according to SIU norms is 1:4/ shift i.e. 300 Staff
Nurses/ day. So, total Staff Nurses required are 300 + 30% Leave reserve,
300+90 = 390
Staff Nurses – 390
Nursing Sister – 109
ANS – 25
DNS – 4
ICUs (Neuro, Cardio, Main Surgical and Main Medical ICU) – 50
Beds
Staff requirement according to SIU norms is 1:1/ shift i.e.150 Staff
Nurses/ day. So, total Staff Nurses required are 150 + 30% Leave reserve,
150+45 = 195
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Staff Nurses – 195
Nursing Sister – 54
ANS – 12
DNS – 1
Nursery (10 Beds)
Staff requirement according to SIU norms is 1:2/ shift i.e. 15 Staff
Nurses/ day. So, total Staff Nurses required are 15 + 30% Leave reserve,
15+4 = 19
Staff Nurses – 19
Nursing Sister – 5
ANS – 1
Labour Rooms (10 Tables)
Staff requirement according to SIU norms is 1 per Table/shift i.e.
30 Staff Nurses/day. So, total Staff Nurses required are 30 + 30% Leave
reserve, 30+9 = 39
Staff Nurses – 39
Nursing Sister – 11
ANS – 3
Major OT’s (Neuro, Cardio Main OT) – 25 Tables
Staff requirement according to SIU norms is 2 per Table/shift i.e.
150 staff nurses/ day. So, total staff nurses required are150 + 30% Leave
reserve, 150+45 = 195
Staff Nurses – 195
Nursing Sister – 54
ANS – 12
DNS – 2
Minor OT (5 Tables)
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Staff requirement according to SIU norms is 1 per Table/ shift i.e.
15 Staff Nurses/day. So, total staff nurses required are 15 + 30% Leave
reserve, 15+4 = 19
Staff Nurses – 19
Nursing Sister – 5
ANS – 1
OPD (Expected 1000 Patients/Day)
Injection room - 1
Blood bank – 1
Paediatric -2
Immunization work – 2
Eye – 1
ENT -1
Pre-anesthetic -1
Bronchoscopic lab -1
Cardiac lab – 1
Vaccination antirabies – 1
Dental -1
Medical -1
Central sample collection center -1
Orthopaedic – 2
Gynae – 2
X-ray – 3
Skin – 2
V. D. center – 2
Chemotherapy -2
Neurology – 1
Microbiology infection control – 2
Psychiatry – 1
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Burns -2
Total staff requirement according to SIU norms – 34/day.
So, total staff nurses required is 34 + 30% Leave reserve, 34+10 = 44
Staff Nurses – 34
Nursing Sister – 10
ANS – 2
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Functions in staffing
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5. Determining training requirements for management’s development
and organizational development.
Steps of staffing
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4. Ascertain that each employee is adequately socialized to
organizational values and unit norms.
5. Use creative and flexible scheduling based on patient care needs to
increase productivity and retention
6. Develop a program of staff education that will assist employees
meeting the goals of the organization.
Philosophy of staffing
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The goal of personnel management therefore should be to concoct
the most appropriate incentive system and to design the specific
working conditions in a way that facilitates the most efficient use
of the human machine.
By structuring jobs in a manner that leads to the most efficient
operation, the engineer believes that he can obtain the optimal
organization of work and the proper work attitudes.
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Nurse administrators believe that the technical and humanistic care
needs of critically ill patients are so complex that all aspects of that
care should be provided by professional nurses.
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Staff the general medical, surgical, obstetrics and gynaecology,
paediatric and psychiatric units to achieve a 2:1 professional-
practical nurse ratio.
Involve the heads of the nursing staffs and all nursing personnel in
designing the department’s overall staffing program.
Empower the head nurse to adjust work schedules for unit nursing
personnel to remedy any staff excess or deficiency caused by
census fluctuation or employee absence.
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Reward employees for long term service by granting individuals
special time requests on the basis of seniority.
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strategic assets and exhibit a true commitment to filling
budgeted positions in a timely manner.
b. All institutions should have documented competencies for
nursing staff, including agency or supplemental and
traveling RNs, for those activities that they have been
authorized to perform.
c. Organizational policies should recognize the myriad needs of
both patients and nursing staff.
Recommendations of S.I.U:
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has been recommended taking into account the workload projected
in the wards and the other areas of the hospital.
2. The posts of nursing sisters and staff nurses have been clubbed
together for calculating the staff entitlement for performing nursing
care work which the staff nurse will continue to perform even after
she is promoted to the existing scale of nursing sister.
8. It is recommended that 45% posts added for the area of 365 days
working including 10% leave reserve (maternity leave, earned
leave, and days off as nurses are entitled for 8 days off per month
and 3 National Holidays per year when doing 3 shift duties).
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Most of the hospital today is following the S.I.U.norms. In this the
post of the Nursing Sisters and the Staff Nurses has been clubbed together
and the work of the ward sister is remained same as staff nurse even after
promotion. The Assistant Nursing Superintendent and the Deputy
Nursing Superintendent have to do the duty of one category below of
their rank.
3. Nursery 1:2
1:1(Nothing mentioned about
4. I.C.U. the shifts)
1:l per table
5. Labour Room
Major - 1 :2 per table
6. O.T.
Minor - 1:l per table
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7. Casualty-
· Blood bank 1
· Paediatric 2
· Immunization 2
· Eye 1
· ENT 1
· Pre anaesthetic 1
· Cardio lab 1
· Bronchoscopy lab 1
· Family planning 2
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· Medical 1
· Dental 1
In addition to the 10% reserve as per the extent rules, 45% posts
may be added where services are provided for 365 days in a year/ 24 hours.
The Nurse-patient Ratio as per the norms of TNAI and INC (The Indian Nursing
Council, 1985)
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4. A.N.S. : 1 for 100-150 beds or 3-4 wards
5. Ward Sister : 1 for 25-30 beds or one ward. 30% leave reserve
6. Staff Nurse : 1 for 3 beds in Teaching Hospital in general ward& 1 for 5
beds in Non-teaching Hospital +30% Leave reserve
7. Extra Nursing staff to be provided for departmental research function.
8. For OPD and Emergency : 1 staff nurse for 100 patients (1 : 100 ) + 30%
leave reserve
9. For Intensive Care unit: (I.C.U.) - 1: l or (1:3 for each shift) +30% leave
reserve.
10. It is suggested that for 250 beded hospital there should be One Infection
Control Nurse (ICN).
For specialised depertments, such as Operation Theatre, Labour Room, etc. 1:25
+30% leave reserve. Norms are not based on Nursing Hours or Patient's Needs here.
Conclusion
The key to success of any hospital primarily depends upon its human resource
than any other single factor.The core determinants of staffing in the hospital
organization are quality, quantity and utilization of its personnel keeping in view the
structure and process. The staffing norms should aim at matching the individual
aspiration to the aims and objectives of the organization.
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