DEVELOPMENT AND IMPLEMENTATION OF A
CLINICAL INPATIENT STAFFING MODEL IN AN AcadeMIC MEDICAL CENTER
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
To describe a method that determines inpatient clinical staffing
requirements utilizing a mathematical equation.
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)
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
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.