Deck 16: Staffing and Scheduling

Question 1

What does a nurse staffing plan take into account?

A) Specific nurse-to-patient ratios per shift.
B) Participation of nurses in projecting staffing needs.
C) Compensation and benefits for each level of staff.
D) The occupancy load of a unit.

Answer 1

Participation of nurses in projecting staffing needs.

Question 2

An important aspect of managing the costs on a unit is to plan accurately for staffing needs.Nurse managers use staffing plans to:

A) Assign staff on the unit on a daily basis.
B) Ensure that days off are planned for the staff.
C) Outline the number of individuals by classification on a per-shift basis.
D) Predict the numbers and classifications of float staff needed to augment regular staff.

Answer 2

Outline the number of individuals by classification on a per-shift basis.

Question 3

In a job interview for a staff position,which of the following indicates your knowledge of patient safety?

A) "Will I be able to get overtime hours on your unit?"
B) "If there is an opportunity to work extra shifts,I would really like that."
C) "Is there a strategy in place to reduce the number of overtime hours on the unit?"
D) "I see no reason why I wouldn't be able to work overtime."

Answer 3

"Is there a strategy in place to reduce the number of overtime hours on the unit?"

Question 4

The difference between staffing and scheduling is that staffing:

A) Puts the right person in the right position.
B) Puts the right person in the right time and place.
C) Refers to the number of nursing hours per patient per day.
D) Accounts for interpretation of benefits and compensation.

Question 5

A nurse manager must also consider a number of internal variables that will affect staffing patterns.Which of the following is an internal variable to be considered?

A) Organizational staffing policies.
B) Provincial/territorial licensing standards.
C) Canadian Nurses Association guidelines.
D) Consumer expectations.

Question 6

The number of adverse events such as falls and pressure ulcers on your unit is increasing.An ideal staffing plan to address this issue would include which of the following?

A) Increasing the total number of staff on the unit.
B) Increasing the staff and registered nurse (RN)hours per patient.
C) Increasing the total number of staff and implementing 12-hour shifts.
D) Increasing the number of RNs and number of RNs with experience on the unit.

Question 7

A particular classification system assigns revenue according to the functional capacity of patients and the progression of patients during their stay in rehabilitation units.More independent patient activities such as prompted voiding require higher staff utilization than do dependent activities but do not result in increased staff resources.This is an example of:

A) Bureaucracy.
B) Concern related to the validity of classification systems.
C) Inadequate reliability of classification systems.
D) Inappropriate subjectivity in making judgements about staffing.

Question 8

In the past year,you have noticed an increase in patient falls on your unit.In reading studies related to staffing and patient outcomes,you realize that you will need to plan for:

A) Higher patient care hours.
B) Safer facilities.
C) Institution of a patient classification system.
D) An increased number of RN positions.

Question 9

Scheduling is a function of implementing the staffing plan by assigning unit personnel to work specific hours and specific days of the week.To retain nursing staff,the nurse manager must schedule:

A) All weekends off.
B) All holidays off.
C) A variety of scheduling options.
D) Rotating shifts.

Question 10

A nurse manager uses many sources of data when planning the unit's workload for the year.Which of the following data must be considered in the planning?

A) Hours of operation of the unit.
B) Trends in the numbers of acutely ill patients on the unit.
C) Maximum work stretch for each employee.
D) Weekend requirements.

Question 11

In evaluating mortality rates,the head nurse on the cardiac unit is surprised to find that they are higher on the weekend than on weekdays.In exploring the reasons for this apparent anomaly,the head nurse focuses on:

A) Availability of diagnostic personnel.
B) Availability of physicians.
C) Communication with on-call providers.
D) Numbers of acutely ill patients.

Question 12

To reduce reliance on overtime hours,an organization develops a strategy for floating nurses during staff shortages.To maximize patient safety and reduce costs,the health care organization:

A) Develops a centralized pool of float nurses.
B) Assigns nurses from less busy units to ones with increased numbers of acutely ill patients.
C) Floats nurses only between units on which the nurses have been cross-trained.
D) Assigns float nurses to basic care only.

Question 13

To prepare staffing schedules,a nurse manager needs to calculate paid nonproductive time.When calculating paid nonproductive time,the nurse manager considers:

A) Work time,educational time,and holiday time.
B) Paid hours minus worked hours.
C) Vacation time,holiday time,and sick time.
D) Paid hours minus meeting time.

Question 14

A small rural hospital has been designated as a critical access hospital.It has 40 beds and an average occupancy rate of 34 beds.To prepare the staffing,the chief nursing officer computes the occupancy as being;

A) 90%.
B) 85%.
C) 75%.
D) 60%.

Question 15

A nurse manager must consider a number of external variables when preparing the personnel budget and projecting the unit's staffing needs.An external consideration is:

A) Organizational staffing policies.
B) Staffing models.
C) Changes in services that will be offered.
D) Department of Health licensing standards.

Question 16

Staff members on your unit raise concern that the number of acutely ill patients on the unit is rising and responsiveness in addressing these needs through appropriate staffing is lacking.They point to increased incidences of adverse and sentinel events on the unit.To address this concern,the best action for your hospital organization is to:

A) Implement a patient classification system immediately.
B) Participate in databases that compare the outcomes and staffing levels versus those of institutions similar to yours.
C) Provide increased numbers of staff to the unit.
D) Ignore such concerns because the number of acutely ill patients is variable.

Question 17

Factor evaluation systems involve classification systems in which:

A) Financial data are used to determine staff-to-patient ratios.
B) Diagnosis-related groups are used to determine the numbers of acutely ill patients on a unit.
C) Interventions and time required for interventions are combined to determine the levels that are required.
D) Financial resources and nursing interventions are combined to determine patient contact hours.

Question 18

As the unit manager you post the staffing plan and compliance reports.This initiative is aimed at:

A) Maintaining unit morale.
B) Complying with national requirements.
C) Demonstrating patient outcomes.
D) Inviting staff participation in decision making.

Question 19

A busy neurologic intensive care unit and a step-down unit are most likely to use which patient classification system?

A) Factor evaluation.
B) Prototype evaluation.
C) Canadian National Database of Nursing Quality Indicators.
D) Agency for Healthcare Research and Quality (AHRQ)system.

Question 20

To maintain patient safety,studies suggest that scheduling should avoid which of the following?

A) Rotating shifts.
B) Weekends.
C) Eight-hour shifts.
D) Mandatory overtime.

Question 21

The growth in evidence on nursing-sensitive indicators has been accompanied by significant controversy regarding the level of nurse staffing required for various groups of patients,primarily in acute-care hospitals.Two major approaches to sufficient staffing have been put forward in Canada.These are? (Select all that apply.)

A) Mandated nurse-patient ratios
B) Increased numbers of registered nurses
C) Development of a staffing plan for a period of time
D) Better staff mix

Question 22

Eschiti and Hamilton (2011)learned that support services and numbers of nonnurse staff are greatly diminished on off-peak shifts leading to increased mortality rates.Which of the following factors influence the risk to patients in off-peak times (weekends and evenings and night shifts)? (Select all that apply.)

A) Rotating shifts
B) Mandatory overtime hours
C) Good staff mix
D) Nurse fatigue

Question 23

Patient classification systems have been developed in an effort to give nurse managers the tools and language to describe the acuity of patients."Sicker" patients receive higher classification scores,indicating that more nursing resources are required to provide patient care.Which of the following describes a factor evaluation system?

A) Subjective and descriptive.
B) More objective.
C) Uses broad categories to predict patient-care needs.
D) Patient-care needs based on diagnosis-related groups.

Question 24

To project staffing needs and to avoid understaffing,it is important that nurse managers consider which of the following?

A) Maximum productive hours.
B) Average nonproductive hours.
C) Minimum benefit hours.
D) Maximum vacation time.

Question 25

Your health care organization has a decentralized system for scheduling.As part of this process,after you have developed a draft schedule,you may need to:

A) Seek budgetary approval.
B) Balance personal schedules against institutional needs.
C) Negotiate the schedule with unit staff.
D) Submit the schedule to a centralized staffing office for review.

Question 26

In reviewing the job description of a nurse manager,the staff members become aware that a nurse manager's role is complex.Which of the following duties are required of a nurse manager? (Select all that apply.)

A) Responsibility for nursing benchmarks.
B) No responsibility for knowledge of staffing benchmarks.
C) Responsibility for planning staffing of unlicensed assistive personnel only.
D) Preparing a unit budget.
E) Changing staffing plans on the basis of service needs.

Question 27

Which of the following decrease the risk of patient mortality rates? (Select all that apply.)

A) Staff burnout.
B) Positive leadership support.
C) Increase of casual or temporary positions.
D) Staffing numbers and levels.