PATIENT CLASSIFICATION
SYSTEM
Click to edit Master subtitle style
PATIENT CLASSIFICATION SYSTEM
• A patient classification system is a means of
categorizing present patients on the basis of certain
care needs that can be clinically observed by the
nurse.
Category I: Minimal Care
• Convalescing patients
• No longer require intensive, moderate or maximum
care.
• Still need supervision at infrequent intervals.
Category II: Moderate Care
• Moderately ill patients
• Recovering from the immediate effects of a serious
illness and/or an operation.
• Require nursing supervision or some assistance
related to ambulating and caring for their own
hygiene.
Category III: Maximum Care
• Need close attention throughout the shift
• Complete care
• Require nursing to initiate, supervise, and perform
most of their activities
• Require frequent and complex meds/tx
Category IV: Intensive Care
• Patients who have a high level of nurse dependency
• Requiring therapy and/or intensive nursing care
• Patients with unstable condition requires frequent
evaluation with adjustment of therapy.
MODIFIED APPROACHES TO
NURSE STAFFING AND SCHEDULING
• Many different approaches to nurse
staffing and scheduling are being tried in
on effort to satisfy the needs of
employees and unit workload demands
for patients care.
Alternating or Rotating Work Shifts
• Although straight shifts are used by
some institutions. The frequency of
alternating between days and evenings
or days and nights or rotating through
all shifts varies among institutions;
sooner nurses may work all three shifts
within 7 days.
Permanent Shifts
• Relive the nurses from stress and health
related problems associated with the
alternating and rotating work shift.
• Develop a sense of belonging to a shift
and feel and work better because the
shift suits her.
• The only disadvantage is that nurses
may not develop an appreciation for the
workload or problems of other shifts.
Block and Cyclical Scheduling
• Uses the same schedule repeatedly with
a six day forward rotations, personnel
are scheduled to work 6 successive days
followed by at least 2 days off.
• The schedule repeats itself every 6
weeks.
• Personnel can be scheduled with every
other weekend off and one day during
the week so that there are no more than
4 consecutive days of work.
Eight (8) Shifts, 5 days Workweek
• The 5-day forty hour workweek became
popular during the late 1940’s.
Variable Staffing
• Variable staffing is a method that uses
patients needs to determine the
number and mix of staff. Time measures
are done for direct and indirect patient
care.
Ten (10) hour day, 4 days workweek
• The shifts are 7 am to 5:00, 1 pm to
11:30 and 9:00 pm to 7:30 am. A cyclical
schedule is used that allows at least 14
hours off between the shifts and a 4 day
weekend every 6 weeks for those who
rotate.
Ten (10) hour shift, 7 day workweek
• Two teams alternate weeks from
Tuesday through Monday; there is no
rotation of shifts.
• Each team consists of permanent day,
evening, and nigh shifts.
Twelve (12) hour shift, 7 day workweek
• The better utilizations of nursing personnel
lower staffing requirements.
• Nurses find it fulfilling because they get to
know their patients more frequently.
• They find that there are fewer
communications gaps and better continuity
of care and improved nurse patient
relationship.
Based on R.A. 5901 –
FORTY PER WEEKLAW
• 40 hr/week – for personnel working in
hospitals with 100 bed capacity or over
or which are located in a 1 M
population.
• 48 hr/week – for personnel who work in
agencies with lesser bed capacity or
which are located in communities with
less than 1 M population
Steps in Determining Number of
Nursing Personnel Needed (DOH)
1. Determine type of hospital
Primary, Secondary or Tertiary
2. Categorize according to levels of care:
Primary Secondary Tertiary
a. Minimal Care 70% 65% 35%
b. Intermediate Care 25% 30% 45%
c. Intensive Care 5% 5% 20%
3. Find the NCH needed by patients per day
and get the sum
Minimal = 1.5 hours
Intermediate = 3 hours
Intensive care = 4.5 hours
4. Total NCH x 365 days
5. Find # of working hours per year
40 hr/week = 8 (hrs/day) x 216 (working days/yr)
= 1,728 working hrs/yr
48 hr/week = 8 hrs/day) x 268 (working days/yr)
= 2,144 working hrs/yr
6. Find the nursing personnel needed:
a. NCH/year
=number of personnel
Working hrs/year
b. Nursing Personnel x 30
=number of relievers
(working days/yr)
c. Numbers of personnel + number of relievers
7. Categorize into Professional and Non-Professionals
• Primary = 55:45
• Secondary = 60:40
• Tertiary = 65:35
8. Distribute by Shifts:
• AM = 45%
• PM = 37%
• Night = 18%
Example
Step 1: Computations for 150 patients in a tertiary
hospital.
Step 2: Categorize according to levels of care
Minimal care = 150 x .35= 52.5
Intermediate care = 150 x .45= 67.5
Intensive care = 150 x .20= 30
150 patients
Step 3. Find the NCH needed by patients/day and
get the sum
• Minimal care = 1.5 hrs x 52.5 = 78.75 or 79
• Intermediate care= 3 hrs x 67.5 = 202.5 or 203
• Intensive care = 4.5 hrs x 30 = 135
417
Total NCH/day
Step 4 Total NCH x 365 days
417 x 365 = 152,205 NCH/yr
Step 5: Find # of working hours per year
40 hr/week = 8 (hrs/day) x 216 (working days/yr)
= 1,728 working hrs/yr
6. Find the nursing personnel needed:
a. 152,205
=88 number of personnel
1,728
b. 88 x 30
= 12 number of relievers
216
c. 88 + 12 = 100 nursing personnel
Step 7. Categorize into Professional and Non-Professionals
Tertiary = 65:35
= 100 x .65 = 65 Professional
= 100 x .35 = 35 Non-professional
Step 8: Distribute by Shifts
• AM = 45%
• PM = 37%
• Night = 18%
PROFESSIONAL NON-PROFESSIONAL
• 65 x .45 = 29 AM 35 x .45 = 15.75 = 16
AM
• 65 x .37 = 24 PM35 x .37 = 12.95 = 13 PM
• 65 x .18 = 12 N 35 x .18 = 6.3 =6N
