RN-NUR2832 Rasmussen College – You are making a staffing assignment knowing that you are short-staffed.

QUESTION

You are making a staffing assignment knowing that you are short-staffed. You have five registered nurses (RNs), two licensed practical nurses (LPNs), and two nursing assistants. Those nine employees need to provide a 12-hour shift of services to 30 clients with a high acuity required to a ratio of nurse to client at 1:3.

Client acuity level

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  • Six acuity level 1
  • Eight acuity level 2
  • Nine acuity level 3
  • Seven acuity level 4

You will use the acuity-based staffing model to develop the staffing assignment based on the needs of the clients. You will use the created template.

NUR2832_Staffing

Instructions

As you create this assignment, include the following in an email to your manager to justify your short-staffing plan:

  • Complete the staffing assignment based on the acuity level.
  • Defend how you would direct the staff to their assigned roles for this shift and provide a rationale for the staffing assignment.
  • Describe how you would communicate with each level of care provider to assure the best outcomes possible.
  • Address how you would ensure client equity in the delivery of services.
  • Provide stated ideas with professional language and attribution for credible sources with correct APA citation, spelling, and grammar.
  • (use the information below)

Staffing Available

  • 5 RN 2 LPN 2 NA
  • 30 patients

Acuity Level 1 – 6 Patients

  1. Room 2301 Susan is a 93-year-old who fell at home and is waiting for nursing home placement who uses a walker and requires assistance to the bathroom and ADLs
  2. Room 2312 Fredrick is a 57-year-old who is recovering from a knee replacement who needs educational reinforcement and is going home today.
  3. Room 2319 Joshua is a 63-year-old who was in for cardioversion and is going home today.
  4. Room 2329 Brian is a 49-year-old who has been diagnosed with hypertension and Alzheimer’s Disease who wanders off the unit and needs assistance with ADLs.
  5. Room 2304 James is a 95-year-old who has osteoarthritis and needs help getting out of bed, bathing, and dressing.
  6. Room 2307 Francis is a 39-year-old who will be discharged today. She received discharge teaching yesterday about her ruptured appendix wound and wants to review the care instructions before she leaves.

Acuity Level 2 – 8 Patients

  1. Room 2302 Brooke is a 33-year-old who was admitted with new-onset DM with uncontrolled blood sugars. She has started on new medications, including insulin, and needs additional patient and family education.
  2. Room 2311 Mark is an 83-year-old who is on isolation for MRSA and is on IV antibiotics and ten other medications.
  3. Room 2320 Jeffrey is a 63-year-old who is non-compliant with his medications and came in with hypertension and crackles in his lungs. He has daily labs and has a wound on his left foot.
  4. Room 2330 Leslie is a 46-year-old who had unstable angina and had a cardiac catheterization yesterday late afternoon and stayed over for observation.
  5. Room 2305 Traci is a 72-year-old who has a history of heart disease, a history of myocardial infarction, and mild dementia.
  6. Room 2308 Alecia is a 33-year-old who was experiencing chest pain and is scheduled for a stress test later today.
  7. Room 2303 Theodore is a 22-year-old who has had DM since he was a 10-years-old who requires medication adjustments.
  8. Room 2318 Bruce is a 45-year-old who was placed on isolation for C-Diff and is on several IV mediations.

Acuity Level 3 – 9 Patients

  1. Room 2306 Amelia is an 83-year-old after a stroke and requires total care.
  2. Room 2313 Audrey is a 78-year-old with newly diagnosed COPD.
  3. Room 2317 Abigail is a 90-year-old who is a diabetic with a chronic leg infection.
  4. Room 2328 Roxanne is an 82-year-old with newly diagnosed lung cancer.
  5. Room 2322 Nancy is a 56-year-old with chronic kidney disease and on peritoneal dialysis.
  6. Room 2323 Dennis is a 35-year-old who was admitted with right upper quadrant pain that radiates to the right shoulder.
  7. Room 2314 Roger is a 46-year-old who is wasted and malnourished. She has severe diarrhea.
  8. Room 2309 Terry is a 59-year-old who has bladder cancer with painless hematuria.
  9. Room 2310 Barry is a 54-year-old who has a history of mitral valve regurgitation.

Acuity Level 4 – 7 Patients

  1. Room 2315 Karen is a 45-year-old who had an acute myocardial infarction with percutaneous coronary intervention.
  2. Room 2321 Fredrick is a 43-year-old who was admitted after an overdose and required close monitoring.
  3. Room 2327, Samantha is a 57-year-old with severe abdominal pain with no bowel sounds.
  4. Room 2324 Robbie is a 62-year-old who has been vomiting and pain in the abdomen.
  5. Room 2325 Jenny is a 58-year-old MVA who has a tracheostomy.
  6. Room 2326 Annette is a 68-year-old who had a bowel resection and colostomy.
  7. Room 2316, David is a 54-year-old with weakness and a decreased level of consciousness.

 

RN 1 RN 2 RN 3 RN 4 RN 5
Room # Acuity Room # Acuity Room # Acuity Room # Acuity Room # Acuity
LPN 1 LPN 2 CNA 1 CNA 2 Staff

  • 5 RN
  • 2 LPN
  • 2 CNA

30 patients

  • 6 acuity level 1
  • 8 acuity level 2
  • 9 acuity level 3
  • 7 acuity level 4
Room # Acuity Room # Acuity Room # Acuity Room # Acuity

ANSWER

Staffing Assignment and Justification for Short-Staffing

Dear [Manager’s Name],

I hope this email finds you well. I wanted to provide you with the staffing assignment plan for the upcoming shift, considering our current short-staffed situation. I have taken into account the acuity levels of our 30 clients and have created a staffing plan based on the acuity-based staffing model. Additionally, I will explain how I intend to direct the staff to their assigned roles, ensure effective communication among the care providers, and maintain client equity in the delivery of services.

Staffing Assignment

Rationale for Staffing Assignment

I have considered the acuity levels of the clients to ensure appropriate staffing ratios and the delivery of safe and effective care. By assigning one RN to three clients, we can maintain a manageable workload for each nurse while meeting the needs of the clients. The RNs will be responsible for the coordination and supervision of care, including medication administration, treatment management, and overall assessment of the clients’ conditions (Clarke, 2008).

LPNs will assist with tasks that fall within their scope of practice, such as medication administration, wound care, and patient education, under the supervision of the RNs. Their presence will help alleviate the workload of the RNs, allowing them to focus on more complex care needs.

CNAs will provide direct patient care and assist with activities of daily living under the supervision of the RNs and LPNs. They will play a crucial role in ensuring the clients’ comfort, mobility, and hygiene needs are met.

Communication with Care Providers

To ensure the best outcomes for our clients, effective communication among the care providers is essential (Lang, 2012). I will establish a structured handoff process at the beginning and end of each shift, where the outgoing and incoming staff will exchange relevant information about the clients’ conditions, care plans, and any changes in their status. This will facilitate continuity of care and promote collaboration among the care team.

Additionally, I will encourage regular team huddles and bedside rounds, allowing for open communication, clarification of care plans, and addressing any concerns or questions from the care providers. These practices have been shown to enhance teamwork and improve patient outcomes.

Ensuring Client Equity

To ensure client equity in the delivery of services, I will emphasize the importance of providing person-centered care to all clients, regardless of their acuity level. Every client deserves individualized attention, respect, and dignity (National Academies Press (US), 2021). I will encourage the care providers to prioritize their tasks based on the clients’ needs and to provide appropriate interventions promptly.

I will also closely monitor the workload of each care provider and make necessary adjustments if any imbalances or additional support are identified. Regular feedback and open communication channels will be maintained to address any concerns and ensure client equity throughout the shift.

In conclusion, I have developed a staffing assignment plan based on the acuity level of our clients. By carefully considering the workload, skill mix, and effective communication strategies, I believe we can provide safe and quality care to our clients, despite the short-staffed situation. Should you have any further questions or require additional information, please feel free to reach out to me.

Thank you for your attention to this matter.

Sincerely,

[Your Name]

[Your Designation]

References

Clarke, S. P. (2008, April 1). Nurse Staffing and Patient Care Quality and Safety. Patient Safety and Quality – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK2676/

Lang, E. V. (2012). A Better Patient Experience Through Better Communication. Journal of Radiology Nursing, 31(4), 114–119. https://doi.org/10.1016/j.jradnu.2012.08.001

National Academies Press (US). (2021, May 11). The Role of Nurses in Improving Health Equity. The Future of Nursing 2020-2030 – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK573898/

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