How To Calculate Nursing Staffing Needs To Ensure Best Patient Outcomes

A hospital’s personnel budget may often be its largest, most expensive resource item. 

It may also be one of the most important safety features of any institution. 

A well-maintained workforce is the skeleton of the healthcare industry. Without it, hospitals would not be able to coordinate patient care and operate effectively. 

But how do you calculate nursing staffing needs to schedule and manage hospitals for the benefit of the staff and patients? 

In this article, we will discuss a staffing formula, several staffing models, and a few tips that can show you how to calculate your nursing staffing needs. 

Table of Contents

• 6 Basic Steps To Calculating Staffing Needs in Healthcare
• 3 Models To Consider Before Calculating Nursing Staffing Needs
• 3 Tips for Calculating Nursing Staffing Needs
• Trusted Managed Services Offers a Customizable and Comprehensive Solution to Your Facility’s Calculated Staffing Needs

6 Basic Steps To Calculating Staffing Needs in Healthcare

The example formula provided was created by the Association of Operating Room Nurses. We will be using theoretical numbers to explain how to calculate nursing staffing needs with this formula.

Remember to keep in mind certain cases may require additional or fewer personnel based on patient acuity. 

To begin the example, say an OR suite has 10 rooms, which must be available and staffed in the following schedule (room/time/day):

• 10 rooms, 8 a.m.-2 p.m., Monday-Friday
• 4 rooms, 2 p.m.-8 pm., Monday-Friday
• 2 rooms, 6 a.m.-8 a.m., seven days a week
• 2 rooms, 8 a.m.-6 p.m., Saturday-Sunday

Step 1: Calculate the Total Hours To Be Staffed Per Week

Multiply the number of rooms by the number of hours per day by the number of days a week to find the total hours needed for staffing.

Per example:

• 10 rooms x 8 hours x 5 days = 400 staffed hours
• 4 rooms x 4 hours x 5 days = 80 staffed hours 
• 2 rooms x 10 hours x 7 days = 140 staffed hours
• 2 rooms x 10 hours x 2 days = 40 staffed hours

Combine all four values and the total staffed hours needed for the week is 660 hours. 

Step 2: Calculate the Total Working Hours of Staff Per Week

Multiply the number of nurses required per room by the total staffed hours per week to find the total working hours of staff per week. For this example, we will suppose two nurses are needed per room.

Per example:

• 2 nurses x 660 hours = 1,320 total hours per week

Step 3: Calculate the Basic Full-Time Equivalent (FTE)

Basic full-time equivalent (FTE) is a unit that measures the total working hours as if all staff are full-time. It can be measured by dividing the total hours per week by 40 hours worked a week. 

Per example:

• 1,320 hours/40 = 33 basic FTE hours

Step 4: Calculate Benefit Relief Per Staff Member

Now calculate the benefit relief per staffed nurse. Using these theoretical values, we might expect these benefit relief hours to be:

• Vacation hours per year = 120 hours
• Holiday hours per year = 60 hours
• Available sick hours per year = 96 hours
• 15-minute breaks out of 260 work days divided by 60 minutes = 65 hours
• 45-minute lunch breaks out of 260 work days divided by 60 minutes = 195 hours

Combine all values to find benefit hours per year for one nurse. In this example, there would be 536 benefit relief hours for one staff member per year. 

Step 5: Calculate Relief FTE

We can now calculate relief FTE by multiplying benefit relief hours by FTE hours and then dividing by hours worked per year (2,080).

Per example:

• 536 benefit relief hours x 33 basic FTE hours/2,080 work hours per year = 8.5 relief FTE hours

Step 6: Calculate the Total Minimum Direct Care Staff

Finally, we add basic FTE to relief FTE to find the minimum of direct care that might be provided by nursing staff.

Per example:

• 33 basic FTE hours + 8.5 relief FTE hours = 41.5 hours

It may be difficult to account for all of this data and run a hospital. Trusted Managed Services can provide you with software to help manage billing, staffing, time tracking, and more to make certain that your staff and patients are accounted for and accommodated. 

3 Models To Consider Before Calculating Nursing Staffing Needs 

The above equation model is not always as simple. Some factors that may affect how you might calculate nursing staffing needs. 

Factors that may affect calculations might include:

• Department
• Number of total staff
• Number of total rooms
• Number of cases
• Hours of service
• Time of year

Considering these factors, some management teams may build their staffing needs around budget, nurse-to-patient ratios, or patient acuity. Let’s discuss how you might calculate nursing staffing needs through the following staffing models. 

#1: Budget-Based Staffing

This staffing model focuses on the distribution of nurses according to nursing hours per patient day (NHPPD). Nursing hours are the total number of hours worked by all nurses on a single unit per day.

The NHPPD figure is the average nursing hours required to care for each patient in a single unit. To calculate NHPPD, divide the average actual nursing hours performed by nurses per patient each day. 

This staffing model often reveals an accurate snapshot of the number of nurses needed on a given floor per day but does not account for special cases or emergencies. 

#2: Nurse-Patient Ratio Staffing

This staffing model is based solely on the number of patients in the unit. Some establishments may use NHPPD along with nurse-patient ratio staffing.

An issue that may arise with this model is that certain units can halt the admission of patients if patient numbers hit the max nurse-patient ratio. Other units, like the emergency department (ED), cannot stop admitting patients. 

Lower nurse-to-patient staffing ratios may lead to higher patient satisfaction, but the minimum number of nurses in a unit may then become the maximum. 

This staffing model may be state mandated for certain departments but also require the use of other models. For example, Massachusetts hospitals may use a budget-based staffing model but are required by law to also use a 1:1 or 1:2 nurse-to-patient ratio in ICU departments. California is the only state that legally requires this model to be used for all departments. 

#3: Patient Acuity Staffing

Patient acuity is the measure of a patient’s condition based on the severity of illness or injury, including but not limited to their physiological and psychological condition. 

The patient acuity staffing model accounts for patient needs, skill sets of nurses on shift, and other objective clinical data to determine the amount of staff needed.

An acuity-based staffing model is patient-centered. It aims to delegate the most skilled nurses to the patient cases that require more adept care, possibly removing unfair burdens on other nurses. 

This model may be more cost-effective when operating under a value-based reimbursement system, where the payments for care delivery are equal to the quality of care.

3 Tips for Calculating Nursing Staffing Needs

Tip #1: Use a Managed Service Provider (MSP) To Quickly Resolve Staffing Needs 

Healthcare managed service providers can use the data you provide to quickly resolve your staffing needs. By providing a readily available pool of temporary medical staff, MSPs can help you fill any vacancies due to shortage or a sudden uptrend in admissions. 

Healthcare MSPs may also provide vendor management service (VMS) to help manage all external tasks and responsibilities relating to the temporary workforce from start to finish. VMSs are usually web-based software that help manage the contingent staff. 

The tasks related to the contingent workforce a VMS manages may include:

• Credentialing
• Hiring 
• Onboarding
• Billing
• Compliance documentation
• Resource planning

These services help hospitals focus on the patients rather than worrying about finding contingent staff to meet nurse-to-patient ratios. 

Trusted Managed Services is a management service provider that you can trust. It is our mission to manage your healthcare teams and departments so you can focus on ensuring the highest quality of care for your patients.

Tip #2: Implement a Staffing Plan

The purpose of a staffing plan is to always have an appropriate number of nurses to ensure the best patient outcomes. For some states, this number is mandated and nurse staffing plans must be implemented in accordance with the law. 

A well-oiled machine requires communication and organization throughout all parts. Staffing plan committees are excellent vehicles for the communication and execution of staffing plans. If your hospital does not have one, consider forming it.

A committee may strengthen communication with executives and/or nurse management agencies to create a practice of standardization of care across multiple departments. Different departments may have varying staffing needs and elements that should be considered to provide the highest quality of patient care.

Elements that may affect your staffing plan between departments may include:

• History of admission trends
• Legal requirements 
• The time it takes to perform unrelated patient tasks (breaks, charting, etc)
• The time it takes to perform patient tasks
• Data that regards incidents where a patient was harmed (medical error, fall, etc.)

Tip #3: Use Appropriate Nurse Staffing Guidelines

Appropriate nurse staffing guidelines, otherwise known as “safe staffing” guidelines, are policies and procedures that ensure the safety of staff and patients. These guidelines act as safety parameters to avoid medical mistakes, nurse burnout, accidents, etc. 

Staffing ratios are often debated and may vary between departments and institutions. For example, National Nurses United recommends this staff ratio for safe staffing:

• Operating Room: 1:1
• Medical/Surgical: 1:4
• Emergency Room: 1:3
• Intensive Care: 1:1
• Psychiatric: 1:4
• Rehabilitation: 1:4
• Labor and Delivery: 1:2
• Pediatrics: 1:3

Patient and staff safety may be a critical factor when considering how to calculate nursing staffing needs. Research has shown that staffing guidelines with safety in mind may lower the odds of injury and reduce patient mortality.

How Appropriate Nurse Staffing Guidelines Benefit Healthcare Facilities 

Patients are not the only parties affected by uneven staffing ratios and neglected safe staffing guidelines. 

Facilities benefit from appropriate staffing ratios because uneven nurse-to-patient ratios create undue burden and stress on nurses. This could lead to burnout and, in turn, cause high turnover rates. 

Appropriate staffing ratios may resolve this by providing an environment where nurses feel supported and able to provide quality care. In response, nurses may have higher job satisfaction and less burnout, helping hospitals retain staff.

Trusted Managed Services Offers a Customizable and Comprehensive Solution to Your Facility’s Calculated Staffing Needs

Trusted Managed Services aims to promote quality care and safety by simplifying your contingent healthcare staffing forces. 

From providing detailed reports on workplace analytics to supplying your workforce with readily available temp workers to relieve shortages — we are the management service provider that can help you manage your institution from top to bottom.

Our management service aims to help provide hospitals with healthcare staffing solutions, time management services, lower vending costs, and more. 

Trusted Managed Services would like to provide you with the opportunity to maximize your institution’s efficacy and organization. Get started by requesting a demo today.