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Staffing Norms:SIU,Bajaj Committee, High Power Committee,INC

DEFINITION
Staffing is selection ,training ,motivating, and retaining of a personnel in the organization. Staffing is the systematic approach to the problems of selecting, training ,motivating and retaining professional and non-professional personnel in any organization.

Philosophy of staffing in nursing


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.

Nurse administrators believe that the health teaching and rehabilitation needs of chronically ill patients are so complex that direct care for chronically ill patients should be provided by professional and technical nurses

Philosophy of staffing in nursing


Nurse administrators believe that patient assessment , work quantification and job analysis should be used to determine the number of personnel in each category to be assigned to care for patients of each type. Nurse administrators believes that a master staffing plan and policies to implement the plan in all units should be developed centrally by the nursing heads and staff of the hospital.

Philosophy of staffing in nursing


Nurse administrator believes the staffing plan should be administered at the unit level by the head nurse , so that selected plan details, such as shift- start time ,number of staff assigned on holidays, and number of employees assigned to each shift can be modified to accommodate the units workload and workflow

Objectives of staffing in nursing


Provides an all-professional nurse staff in critical care units, operating rooms ,labour and delivery unit and emergency room. Provide sufficient staff to permit 1:1 nurse-patient ratio for each shift in every critical care unit. Staff the general medical, surgical ,obstetrics and gynecology ,pediatric and psychiatric units to achieve a 2:1 professional practical nurse ratio.

Objectives of staffing in nursing


Provide sufficient nursing staff in general medical surgical and obstetric ,pediatric and psychiatric units to permit a1:5 nurse-patient ratio, on a day and afternoon shifts and 1:10 nurse-patient ratio on night shift. Involve the heads of the nursing staff and all nursing personnel in designing the departments overall staffing programme.

Objectives of staffing in nursing


Post time schedules for all personnel at least eight weeks in advance. Empower the head nurse to adjust work schedules for unit nursing personnel to remedy any staff excess or deficiency caused by census fluctuation or employees absence.

Objectives of staffing in nursing


Inform each nursing employees that requests for specific vacation or holiday time will be honored within the limits imposed by patients care. Reward employees for long term service by granting individuals special time requests on the basis of seniority.

Factors affecting staffing


Acutely ill- Requires 8-10 hrs per patient per day. i.e direct nursing care in 24 hrs have to be 1:1 or 2:1 Moderately ill Requires 3.5 hrs per patient per day so NPR IS 1:3 in teaching and 1:5 in non- teaching hospitals Mildly ill Requires 1-2 hr per patient per day and for such patients 1:6 or 1:10 NPR is to be adequate. - Recommendations are given by Central Council of Health of India

Stafffing formulas
No.needed Days of week No.of days/workweek No of people required 1 X 7 5 1.4 2 X 7 5 2.8 3 X 7 5 4.2 4 X 7 5 5.6 It does not include vacations , holidays abseentism or staff development time

Stafffing formulas
Vacation coverage No. of vacations days per year x No of full-time people at that skill level = Total vacation days by skill level

Total vacation days by skill level total days worked per person per year = no of full- time people needed for vacation relief coverage

Stafffing formulas
Holidays coverage No. of personnel x no of holidays = No. of holidays needing coverage No of holidays needing coverage No of days worked per y ear per person = No of personnel required for holidays coverage per year

Stafffing formulas
Staff development coverage No of hrs recommended for staff development per year per person x no of staff = No of hrs per year for development needing relief coverage No. of staff development hrs needing coverage Hrs worked/day total days worked /person = Full- time personnel required for staff development coverage

S I U- staff inspection unit

The Staff Inspection Unit (S.I.U.) is the unit which has recommended the nursing norms in the year 1991-92. As per this S.I.U. norm the present nurse-patient ratio is based and practiced in all central government hospitals.

Recommendations of S.I.U
The norms for providing staff nurses and nursing sisters in Government hospital is given in this report. The norm has been recommended taking into account the workload projected in the wards and the other areas of the hospital. 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.

Recommendations of S.I.U

Out of the entitlement worked out on the basis of the norms, 30%posts may be sanctioned as nursing sister. This would further improve the existing ratio of 1 nursing sister to 3.6. staff nurses fixed by the government in settlement with the Delhi nurse union in may 1990.

Recommendations of S.I.U
The assistant nursing superintendent are recommended in the ratio of 1 ANS to every 4.5 nursing sisters. The ANS will perform the duty presently performed by nursing sisters and perform duty in shift also. The posts of Deputy Nursing Superintendent may continue at the level of 1 DNS per every 7.5 ANS

Recommendations of S.I.U
There will be a post of Nursing Superintendent for every hospital having 250 or beds. There will be a post of 1 Chief Nursing Officer for every hospital having 500 or more beds. 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).

The Nurse-patient Ratio as per the S.I.U. Norms


1. General Ward 2. Special Ward - ( pediatrics, burns, neuro surgery, cardio thoracic, neuro medicine, nursing home, spinal injury, emergency wards attached to casuality) 3. Nursery 4. 5. 6. I.C.U. Labour Room O.T. 1:6 1:4

1:2 1:1(Nothing mentioned about the shifts) 1:l per table 1:l per table

The Nurse-patient Ratio as per the S.I.U. Norms


7. Injection room OPD Attendance upto 100 patients per day 1 staff nurse 120-220 patients: 2 staff nurses 221-320 patients: 3 staff nurses 321-420 patients: 4 staff nurses

The Nurse-patient Ratio as per the S.I.U. Norms


. OPD NAME OF THE DEPARTMENT Blood bank Paediatric Immunization Eye ENT Pre anaesthetic Cardio lab Bronchoscopy lab Vaccination anti rabis Family planning Medical Dental

1 2 2 1 1 1 1 1 1 2 1 1

The Nurse-patient Ratio as per the S.I.U. Norms


Central sample collection centre Orthopaedic Gyne Xray Skin V D centre Chemotherapy Neurology Microbiology Psychiatry Burns 1 1 2 2 3 2 2 2 1 2 1

The Nurse-patient Ratio as per the S.I.U. Norms


Casualtya. Casualty main attendance up to 100 patients per day thereafter b.for every additional attendance of 35 patients c. gynae/ obstetric attendance d. thereafter every additional attendance of 15 patients. 3 staff nurses for 24 hours, 1:1per shift.

1:35 3 staff nurses for 24 hours, 1:1/ shift 1:15

The Nurse-patient Ratio as per the norms of TNAI and INC (1985)
Chief Nursing Officer :1 per 500 beds

Nursing Superintendent :1 per 400 beds or above D.NS. : 1 per 300 beds and 1 additional for every 200 beds A.N.S. :1 for 100-150 beds or 3-4 wards

Ward Sister :1 for 25-30 beds or one ward. 30% leave reserve

The Nurse-patient Ratio as per the norms of TNAI and INC (1985)
Staff Nurse :1 for 3 beds in Teaching Hospital in general ward& 1 for 5 beds in Non-teaching Hospital +30% Leave reserve Extra Nursing staff to be provided for departmental research function. For OPD and Emergency :1 staff nurse for 100 patients (1 : 100 ) + 30% leave reserve

The Nurse-patient Ratio as per the norms of TNAI and INC (1985)
For Intensive Care unit: (I.C.U.)- 1:l or (1:3 for each shift ) +30% leave reserve. 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.

HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION (1987-1989)

Set up by the Government of India in July 1987, under the chairmanship of Dr Jyothi former vice-chancellor of SNDT Women University, Mrs Rajkumari Sood, Nursing Advisor to Union Government as the membersecretary and CPB Kurup, Principal, Government College of Nursing, Bangalore and the then President, TNAI also one of the prominent members of this committee.

Terms of Reference of the Committee


To look into the existing working conditions of nurses with particular reference to the status of the nursing care services both in the rural and urban areas. To study and recommend the staffing norms necessary for providing adequate nursing personnel to give the best possible care, both in the hospitals and community.

To look into the training of all categories and levels of nursing, midwifery personnel to meet the nursing manpower needs at all levels of health services and education.

Terms of Reference of the Committee


To study and clarify the role of nursing personnel in the health care delivery system including their interaction with other members of the health team at every level of health service management.

To examine the need for organized nursing services at the national, state, district and local levels with particular reference to the need for planning service with the overall care system of the country at the respective levels.
To look into all other aspects, the Committee will hold consultations with the State governments.

Terms of Reference of the Committee


To study and clarify the role of nursing personnel in the health care delivery system including their interaction with other members of the health team at every level of health service management.

To examine the need for organized nursing services at the national, state, district and local levels with particular reference to the need for planning service with the overall care system of the country at the respective levels.
To look into all other aspects, the Committee will hold consultations with the State governments.

Recommendations of this group are Appointment of ANM/LHV/HS/PHC, 1 ANM for 2500 population (2 per sub center), 1 ANM for 1500 population in hilly areas, 1 health supervisor for 7500 population (for 3 ANMs), 1 public health nurse for 1 PHC (30,000 population and 4 health supervisor), 2 district PHN officers in each district. Simplification of recording system. Adequate provision of supplies, drugs, etc, is made. Gazetted rank for the post of PHN and above grade. Specific standing orders be made available to ANM/LHV/HS.

BAJAJ COMMITTEE, 1986


Also known as Expert Committee on Health Manpower Planning Production and Management. Headed by Dr S Bajaj, a professor of All India Institute of Medical Sciences, New Delhi. Committees Recommendations are Enunciate a National Health Manpower Policy. Formulate a National Policy on Education in Health Sciences. Conduct a country wide survey of health manpower. Upgrade and improve medical and health educational infrastructure and technology.

BAJAJ COMMITTEE, 1986


Appoint nurses as follows: 1 staff outpatient nurse/100 outpatients. 1 staff nurse/10 hospital beds + 30% extra as leave reserve. 1 ward sister/25 beds + 30% extra as leave reserve.

1 nursing superintendent for hospital with 200 beds or more.

BAJAJ COMMITTEE, 1986


Appoint nurses as follows 1 deputy nursing superintendent for hospital with 300 beds or more. In rural areas, establish a Community Health Center for every 100,000 population. Establish Educational Commission for Health Services on the lines of the university Grants Commission.

BAJAJ COMMITTEE, 1986


Set up Health Sciences University in all states and union territories. Establish Health Manpower Cell at the center and in the states. Vocationalize education at 10+2 level as regards health related fields. This will lead to the availability of good quality paramedical personnel.