C HAPTER 11: S TAFFING AND S CHEDULING
Yoder-Wise: Leading and Managing in Nursing, 8th Edition
MULTIPLE CHOICE
1. Staff members on your unit raise concern that there is rising acuit y on the
unit and lack of responsiveness in addressing these needs through
appropriate staffing. They point to increased incidences of adverse and
sentinel events on the unit. To address this concern, your hospital
organization would do best to:
a. implement a patient -classification system immediatel y.
b. participate in databases that compare the outcomes and staffing
levels versus those of similar institutions.
c. provide increased numbers of staff to the unit.
d. ignore such concerns because acuit y is variable.
ANS: B
Staff morale suffers both when acuit y models indicate a gap between
staffing and acuit y and when there is no model but perceived acuit y
that is not being addressed. A truer approach is to monitor patient
outcomes and participate in national databases that measure staffing
levels through comparison with like institutions.
TOP: AONE competency: Knowledge of the Health Care
Environment
,2. A particular classification system assigns revenue according to the
functional capacit y of patients and the progression of patients during their
stay in rehabilitation units. More independent pat ient activities, such as
prompted voiding, require higher staff utilization than dependent
activities but do not result in increased staff resources. This is an example
of:
a. bureaucracy.
b. concern related to the validit y of classification systems.
c. inadequate reliability of classification systems.
d. inappropriate subjectivit y in making judgments about staffing.
ANS: B
Validit y of categories and implications for staffing levels are in
question in this situation because staffing levels are not reflective of
the levels of activit y required for patient care.
TOP: AONE competency: Business Skills
3. In the past year, you have noticed an increase in patient falls on your unit.
In reading studies related to staffing and patient outcomes, you realize
that you will need t o plan for:
a. higher patient care hours.
b. safer facilities.
c. institution of a patient -classification system.
d. an increased number of RN positions.
ANS: D
, Lower fall rates are shown to be related to higher total nursing hours
and a higher percentage of nursing hours supplied by RNs.
TOP: AONE competency: Business Skills
4. A strategy to increase RN staff retention at Valley Hospital includes:
a. better compensation and benefits.
b. clearer position descriptions.
c. lay-offs of nursing assistants.
d. adequate staffing to mee t acuit y levels.
ANS: D
Over the past decade, a significant amount of research has been done in
the United States to evaluate links among nursing staffing, workloads,
skills mix, and patient outcomes. An analysis of this research
demonstrates that ensuri ng adequate staffing levels has been shown,
among other things, to improve nurse retention and job satisfaction.
TOP: AONE competency: Business Skills
5. In evaluating weekend mortalit y rates, the head nurse on the cardiac unit
is surprised to find that the y are higher than on weekdays. In exploring the
reasons for this apparent anomal y, the head nurse focuses on:
a. availabilit y of diagnostic personnel.
b. availabilit y of physicians.
c. communication with on -call providers.
d. acuit y level of patients.
Yoder-Wise: Leading and Managing in Nursing, 8th Edition
MULTIPLE CHOICE
1. Staff members on your unit raise concern that there is rising acuit y on the
unit and lack of responsiveness in addressing these needs through
appropriate staffing. They point to increased incidences of adverse and
sentinel events on the unit. To address this concern, your hospital
organization would do best to:
a. implement a patient -classification system immediatel y.
b. participate in databases that compare the outcomes and staffing
levels versus those of similar institutions.
c. provide increased numbers of staff to the unit.
d. ignore such concerns because acuit y is variable.
ANS: B
Staff morale suffers both when acuit y models indicate a gap between
staffing and acuit y and when there is no model but perceived acuit y
that is not being addressed. A truer approach is to monitor patient
outcomes and participate in national databases that measure staffing
levels through comparison with like institutions.
TOP: AONE competency: Knowledge of the Health Care
Environment
,2. A particular classification system assigns revenue according to the
functional capacit y of patients and the progression of patients during their
stay in rehabilitation units. More independent pat ient activities, such as
prompted voiding, require higher staff utilization than dependent
activities but do not result in increased staff resources. This is an example
of:
a. bureaucracy.
b. concern related to the validit y of classification systems.
c. inadequate reliability of classification systems.
d. inappropriate subjectivit y in making judgments about staffing.
ANS: B
Validit y of categories and implications for staffing levels are in
question in this situation because staffing levels are not reflective of
the levels of activit y required for patient care.
TOP: AONE competency: Business Skills
3. In the past year, you have noticed an increase in patient falls on your unit.
In reading studies related to staffing and patient outcomes, you realize
that you will need t o plan for:
a. higher patient care hours.
b. safer facilities.
c. institution of a patient -classification system.
d. an increased number of RN positions.
ANS: D
, Lower fall rates are shown to be related to higher total nursing hours
and a higher percentage of nursing hours supplied by RNs.
TOP: AONE competency: Business Skills
4. A strategy to increase RN staff retention at Valley Hospital includes:
a. better compensation and benefits.
b. clearer position descriptions.
c. lay-offs of nursing assistants.
d. adequate staffing to mee t acuit y levels.
ANS: D
Over the past decade, a significant amount of research has been done in
the United States to evaluate links among nursing staffing, workloads,
skills mix, and patient outcomes. An analysis of this research
demonstrates that ensuri ng adequate staffing levels has been shown,
among other things, to improve nurse retention and job satisfaction.
TOP: AONE competency: Business Skills
5. In evaluating weekend mortalit y rates, the head nurse on the cardiac unit
is surprised to find that the y are higher than on weekdays. In exploring the
reasons for this apparent anomal y, the head nurse focuses on:
a. availabilit y of diagnostic personnel.
b. availabilit y of physicians.
c. communication with on -call providers.
d. acuit y level of patients.
