NSG 4150 Personnel Budget Case Study


NSG 4150 Directions: Complete the case study below by answering each question in Part A and B. Utilize a minimum of two scholarly resources (such as academic peer-reviewed journal articles or refereed sources) to support responses to Part A of the case study. For Part B use the NSG4150_Personnel_Budget_Case_Study_Worksheet PDF provided in Canvas. This document is for illustration only. Do not make any edits to the spreadsheet. The assignment does not require a formal written paper; however, when preparing the paper, please use an APA-style title page with running head, and reference page is required. Scenario: Mary Jane Smith has recently accepted a position as nurse manager on 1 West, a medical surgical nursing unit at Mercy Hospital Center. Part A: Identify two of the nursing-sensitive indicators Mary Jane should consider in making staffing Discuss how nursing-sensitive indicator data (for each indicator chosen) can be utilized to enhance the safety and quality of patient care. Consider the following list of considerations to be made related to acuity: comorbid conditions complex medical needs family/social support polypharmacy psychological/cognitive status complex treatment plans number of providers involved a. For this aspect, explain the ways in which nursing staffing is impacted by patients who may have two of these issues which would create a higher acuity level for the patient. This part of the discussion must include an explanation of two of the considerations listed. Part B: Mary Jane has been asked by the Chief Nursing Officer to prepare a personnel budget for the coming fiscal year. Mary Jane has collected the following information, in addition to what she has determined based on nursing-sensitive indicator data discussed in Part A. This information is also listed on the PDF document (in the unit module) for illustration. Patient Data Average Daily Census 28 Unit Capacity 30 Total Care Hours 96,360 Staff Data Total Hours/employee/year 2,080 Average Salary per Employee Category RN $36.00/hour LPN $22.00/hour Nurse’s Aide $12.00/hour Answer each of the following questions within the paper: Calculate the number of full-time equivalents (FTEs) that would be needed. Use the following formula and show your Take the total care hours and divide by the total hours for the year. Explain what hours per patient day (HPPD) are and how the acuity of the unit would affect HPPD? Explain how diagnosis-related groups (DRG’s) and Case Mix Index (CMI) affects hours per patient day. Review the staffing plan for last year. What outcomes would you use to evaluate this staffing plan? Based on this data, would you recommend any changes for the upcoming year?


NSG 4150 Introduction

  Patients in all contexts demand treatment tailored to their unique needs rather than what is most convenient for medical professionals. Since challenges, including poor clinical results and nurse staffing shortages, have piqued public attention, a reformed healthcare system has been a concern. Thanks to Florence Nightingale, who advocated for better clinical practice and opened the way to introduction of quality-of-care indicators (Afaneh, & Abu-Moghli, 2020).

NSG 4150 Nursing-sensitive indicators

   Nurse-sensitive indicators are parameters that correlate a patient’s health and recovery to a nurse’s work performance (Manrong et al., 2017). Staffing decisions refer to the funding allotted to nurses based on the number of nursing hours per patient each day. It may be summarized as the patient-to-nurse ratio. AHRQ uses nurse staffing indicators to assess the quality of health care. These indicators are based on the structure, process, and outcomes of nursing care.

Structural: It covers patient- and nursing-related information. A patient aspect relates to the patient’s age, gender, duration of sickness, and duration of surgery if one is warranted. Nursing-related hours can include the number of hours a nurse works per patient throughout the day.

Process indicators: The nursing process is defined in this area as the nurse’s clinical opinion and verdict. It assesses patient evaluation techniques and treatment approaches. Job satisfaction in nursing is seen by many as its indicator.

Outcome terms depict patient outcomes that have been proven to be nursing-sensitive since they are reliant on the quality of care. These include bedsores and falls. However, other clinical effects, such as hospital readmissions and heart attacks, are linked to other aspects of clinical care and are not deemed nursing-sensitive.

How nursing-sensitive indicator data is used

Nursing-sensitive indicators can be used to improve the safety of patients by assessing vital signs and giving a professional judgment on the best course of action for the patient. The nurse monitors the patient’s clinical care in order to control pain and ascertain whether or not the patient is capable of self-care. The collected data is often used to improve the delivery of high-quality medical care to all patients. Outcome indicators depict the advancement of a patient’s healthcare services.

Nurse staffing, urinary tract infection, and pneumonia

Nurse staffing is assigning nurses to provide care for patients based on the number of hours the nurse is scheduled to work. Patients with urinary infections can self-care once they are no longer susceptible. Pneumonia is also not contagious, but it requires immediate nursing care to provide medical interventions.

Part B:

Average Salary per Employee Category

RN $36.00 per hour

LPN $22.00 per hour

Nurse’s Aide $12.00/hour

Patient Data

Average Daily Census 28

Unit Capacity 30

Average HPPD 8.8

Total Care Hours 96,360

Staff Data

Total Hours/employee/year 2,080

Q1: Calculate the number of FTEs) required.

Part-time employee x 15 hours per week x 30 weeks = 450

Total hours =96360 and so FTEs per month=96360 divided by 2080=46.33

Annual FTE = 46.33X12 giving 555.93

Q2: The effect of acuity unit on HPPD

  Acuity refers to the level of care offered by a nurse to patients, whereas HPPD signifies Hallucinogen Persistent Perception Disorder. When dealing with HPPD patients, unit acuity is likely to suffer since these patients require round-the-clock healthcare services from a nurse, and other patients with far less care may feel vetoed (Kirk, 1990). In addition, HPPD illnesses are traumatic and demand optimal support.

Q3: DRG’s and Case Mix Index

   Knowing Diagnosis Related Groups (DRGs) and categorizing patients in a statistical manner enables care providers to determine which individuals and groups require more medical care than others. Grouping the patients lowers the amount of time it might take to treat minor health issues.

Q4: According to the previous year’s staffing plan, employees were understaffed compared to HPPD patients who required comprehensive care. Therefore, I will advocate for an increment in FTEs in order to improve healthcare quality while also providing healthcare workers with time to relax.


Knickman, J. R. & Elbel, B. (2019). Jonas and Kovner’s health care delivery in the United States (12th ed.). New York, NY: Springer Publishing. Kirk, R. (1990). Using workload analysis and acuity systems to facilitate quality and productivity.

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