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TITLE:  DEVELOPMENT AND IMPLEMENTATION OF A CLINICAL INPATIENT STAFFING MODEL IN AN AcadeMIC MEDICAL CENTER

AUTHORS: S.J. Carlson, MMSc, RD, CSP, LD, CNSD; M.E. Caruth, MS, RD, LD; B.A. Clearman, RD, LD; P.A. Kissack, MS, RD, LD; B.J. Reimer, RD, LD; The University of Iowa Hospitals and Clinics, Iowa City, IA

LEARNING OUTCOME: To describe a method that determines inpatient clinical staffing requirements utilizing a mathematical equation.

 

TEXT: Clinical nutrition managers must determine adequate and equitable dietitian staff assignments.  An accurate staffing model includes all components of a Registered Dietitianís assignment that meet an institutionís Standards of Practice.  These components are considered direct patient care and include nutrition assessment, education, daily patient monitoring, and health care team rounds.  The model should also include time for non-direct patient care activities such as meetings, travel time, and other administrative responsibilities.  Our model allots time for direct and non-direct patient care.  Direct patient care is determined by the following staffing equation, which calculates direct patient care time needs for each nursing care unit in hours/week.

 

Total Direct Time = Initial Assessments/week * 0.75 (hours/assessment) + Follow-up Assessments/week * 0.75 (hours/assessment) + Education Time (hours/week) + Rounds (hours/week) + Monitoring Time (hours/week)

 

Monthly-computerized reports provide the number of required nutrition assessments and education time by nursing care unit.  Rounds and monitoring time are based on our dietitian surveys.  Non-direct patient care time is assigned by adding ten hours per week per dietitian FTE. 

Implementation involves comparing each inpatient dietitian assignment to the model.  Adjustments are made in nursing care unit assignments in order that each Registered Dietitianís FTE approximates forty hours per week. 


For additional questions or comments on the model, click here.


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