Scenario: You have just been hired as a unit manager for a 15-bed pediatric unit. One of your first priorities is to create a staffing chart. However, first you will need to calculate your FTEEs and salary costs. After analyzing the unit budget report, you find that the average daily census during the last fiscal year was 12.5 patients. You also find that the acuity during this time is as follows:

Acuity 1: 3 patients

Acuity 2: 7 patients

Acuity 3: 2.5 patients

You check the staffing manual to find the following nurse hours per patient day (NHPPD):

Acuity 1: 10 NHPPD

Acuity 2: 16 NHPPD

Acuity 3: 20 NHPPD

Part I: Calculate FTEEs

Using the information provided in the scenario, the acuity levels, and the NHPPD requirements, first calculate the number of FTEEs needed to staff the unit 24 hours a day, 7 days a week. In your calculation, remember to factor in a 1.2 replacement factor for days off and vacation and a 0.1 replacement factor for nonproductive time. Record your calculations in the Staffing Chart Template.

Part II: Calculate Salary Costs

Based on the FTEEs you calculated in Part I, determine the proportion of registered nurses (RNs) to nursing assistants (NAs) you will need. Then, calculate the salary cost for each person by using the hourly wage multiplied by 2,080 (number of hours worked per year), then add 30% to cover benefits. Use the following to make your calculations:

• RN salary: $87,880 per year (average of $32.50 per hour plus 30% for benefits = $42.25 per hour)
• NA salary: $41,912 per year (average of $15.50 per hour plus 30% for benefits = $20.15 per hour)

Total the salary costs to determine your initial budget.

Part III: Create a Staffing Chart

Compare your initial budget with the units staffing budget of $1,500,000. If your calculated staffing plan exceeds the allocated unit budget, explain alternative approaches and how you might reduce personnel costs while still meeting staff needs for the nursing unit.

Based on the final FTEEs that you calculated and the ratio of RNs to NAs you need to meet your staffing budget, create a staffing chart using the provided template. Assume that nurses on this unit work 12-hour shifts (7:00 a.m. to 7:00 p.m., and 7:00 p.m. to 7:00 a.m.).

Part IV: Staffing Charts for Effective Nursing Practice

Now that you have developed a proposed staffing chart:

1. Explain the factors you should consider to improve health care delivery, improve patient outcomes, and provide quality, effective nursing care.
2. Explain how your proposed staffing chart addresses factors for effective nursing practice.

Part I: Calculating FTEEs

FTEEs _______________

Part II: Calculating Salary Costs

Number of RNs: __________________

Salary cost for RNs: ________________

Number of NAs: __________________

Salary cost for NAs: ________________

Total salary cost: ___________________

Comparison with units staffing budget: ____________________________________________________