Methods for Assessing Inpatient Nurse Staffing Requirements

by James M. Tien

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A Johns Hopkins model for determining nursing needs of hospital patients is modified and applied to New York City's municipal hospitals. Statistical models reveal demands for nurses in light of (1) patient needs and (2) nurse days off (absenteeism and sickness). The analysis considers demands for permanent and per-diem nursing staffs. A new staffing standard, derived from the nurse requirement model (using data from the Hopkins study and from a survey of patient needs in HHC hospitals), is used to assess the requirements of two large municipal hospitals. A nurse floating pool should be established in each HHC hospital to meet patient demands beyond what can be satisfied by the fixed staff. The pool should include all per diems and between 5.5 and 12.2 percent of the fixed staff. The flexibility inherent in a floating pool would eliminate the need for each hospital to hire between 3 and 9 percent additional fixed staff. Procedural problems in establishing such a pool are discussed.

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