The West Palm Beach VA Medical Center (WPB VAMC) Nursing Service recently completed the Fiscal Year 2014 Nursing Staffing Methodology Process for a national VA Nursing Personnel Directive. Under the leadership of Amber M. Thomas, MSN, RN, Acting Staffing Methodology Coordinator, and Ashlyn Powell, MHA, Administrative Fellow, the team incorporated nursing personnel from all units along with nursing administration in the decision-making process.The staffing methodology allowed unit staff members to collaborate and determine appropriate Nursing Hours Per Patient Day (NHPPD) for their respective units. The NHPPD is derived from the amount of direct care that is provided to patients on their respective units. Direct care responsibilities are defined as “all patient or resident-centered nursing activities performed by staff assigned to the unit in the presence of the patient.”
The NHPPDs were utilized by the inpatient units to provide adequate and appropriate staffing levels for the units in terms of Registered Nurses (RN), Licensed Practical Nurses (LPN) and Nursing Assistants (NA). The NHPPD and staffing considerations are determined through an in-depth assessment of current staffing and future needs of the inpatient units. Each inpatient unit was tasked with creating a Unit Based Panel (UBP), which is comprised of personnel from varying disciplines (i.e. RN, NA or LPN). Each UBP created a narrative that detailed the unique roles and responsibilities for the unit. In addition, the team determined the appropriate staffing needed to meet the Average Daily Census (ADC) Fiscal Year to date for the unit. This data was input in a staffing grid that provides the NHPPD. The unit-specific information was then compiled and provided to the Facility Expert Panel (FEP). The FEP reviewed the narrative and staffing information for each unit. After discussion among the UBP and FEP members, the group confirmed the NHPPDs were appropriate. The findings were presented to Senior Leadership, who approved the recommendations for the unit NHPPDs.
The FY 2014 Inpatient Staffing Methodology for VHA Nursing Personnel at West Palm Beach VAMC revealed that the facility has adequate staffing numbers to support patient care. The methodology showed that the hospital is staffed appropriately with an additional 3.2 FTEEs. Given the frequent fluctuations in patient care needs, the nursing leadership will monitor and appropriately adjust staffing on a daily basis. Per the Directive, we will review staffing on an annual basis to meet the needs of our patients and staff.
“When you empower nurses, you improve outcomes. If you want proof of that, look no further than the WPB VAMC and the Nursing Staffing Methodology. Staffing Methodology provided a snapshot of where our resources were and where they needed to be.” – Kathleen Bykowicz, Acting Associate Director of Patient Care Services.
