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PATIENT CLASSIFICATION SYSTEM
PATIENT CLASSIFICATION SYSTEM
• Means of categorizing present patients on the basis of certain care needs that can be clinically observed by the nurse.
CATEGORY I. Self-care/Minimal Care
• Minimal care is given to patients who are convalescing and who no longer require intensive, moderate or maximum care.
CATEGORY I. Self-care/Minimal Care
• Patients who require diagnostic studies, minimal therapy, less frequent observations, and daily care for minor conditions and who are awaiting elective surgery.
CATEGORY II. Moderate Care
• Care given to patients who are moderately ill or are recovering from the immediate effects of a serious illness and/or an operation.
CATEGORY II. Moderate Care
• Patients require nursing supervision or some assistance related to ambulating and caring for their own hygiene.
CATEGORY III. Maximum Care
• Given to patients with who need close attention throughout the shift, that is complete care for patients who require nursing to initiate, supervise and perform most of their activities or who require frequent and complex medications or treatments.
CATEGORY IV. Intensive Care
• Given to acutely ill patients who have a high level of nurse dependency, including those requiring intensive therapy and/or intensive nursing care and whose unstable condition requires frequent evaluation with adjustment of therapy.
PERENTAGE OF PATIENTS IN VARIOUS LEVELS OF CARE
Types of Hospital
Minimal Care
Moderate Care
Intensive Care
Highly Specialized
Care
Primary Hospital
Secondary Hospital
Tertiary Hospital
Special Tertiary Hospital
70
65
30
10
25
30
45
25
5
5
15
45
-
-
10
20
CATEGORIES OR LEVELS OF CARE OF PATIENTS, NURSING CARE HOURS NEEDED PER
PATIENT PER DAY AND RATIO OF PROFESSIONAL TO NON-PROFESSIONALS
LEVELS OF CARE NCH needed per patient per day
Ratio of Professionals to Non-professionals
Level I
Self Care or Minimal Care
Level II
Moderate or Intermediate
Level III
Total or Intensive Care
Level IV
Highly Specialized or Critical Care
1.50
3.0
4.5
6.0
7 or higher
55:45
60:40
65:35
70:30
80:20
TOTAL NUMBER OF WORKING AND NON-WORKING DAYS AND HOURS OF NURSING PERSONNEL PER YEAR
Rights and Privileges Given Each Personnel per Year
Working Hours per week
40 hrs 48 hrs
1. Vacation Leave
2. Sick Leave
3. Legal Holidays
4. Special Holidays
5. Special Privileges
6. Off-duties as per R.A. 5901
7. Continuing Education Program
Total Non-working Days per Year
Total Working Days per Year
Total Working Hours per Year
15
15
10
2
3
104
3
152
213
1,704
15
15
10
2
3
52
3
100
265
2,120
Relievers Needed
1. Average Number of Leaves taken each Year ……… 15
a. Vacation Leave ………………………… 10
b. Sick Leave ……………………………… 5
2. Holidays ………………………………………………… 12
3. Special Privileges as per CSC MC #6 s. 1996………. 3
4. Continuing Education Program for Professionals …... 3
Total Average Leaves ………………………………….. 33
**** 33/213 = 0.15 per person
**** 33/265 = 0.12 per person
STAFFING FORMULA (by L. Venzon)
• Studies shown that the morning shift needs the most number of nursing personnel, that is 45%, the afternoon shift needs about 37% and the night shift only about 18% because more nursing care is given during the morning and afternoon shifts than during the night shift.
The procedure for computing for the number of staff needed in the in-patient areas of the hospital is as follows:
• Sample Problem:
Find the number of nursing personnel needed for 250 patients in a tertiary hospital.
1. Categorize the number of patients according to the level of care needed by hospital classification
a. Total number of patients x percent at each level of care
250 pts x 0.30 = 75 pts. needing minimal care
250 pts x 0.45 = 112.50 pts. needing moderate care
250 pts x 0.15 = 37.50 pts. needing intensive care
250 pts x 0.01 = 25 pts. Needing highly specialized care
250 pts.
2. Find the total number of nursing hours needed by the patients per day at each categorized level
a. Number of patients at each level average nursing hours needed per day
75 pts x 1.5 (NCH needed at Level I) = 112 NCH/day
112.5 pts x 3 (NCH needed at Level II) = 337.60 NCH/day
37.5 pts x 4.5 (NCH needed at Level III)= 168.75 NCH/day
25 pts x 6 (NCH needed at Level IV) = 150 NCH/day
2. Find the total number of nursing hours needed by the patients per day at each categorized level
b. Get the sum of nursing hours in various levels
112 NCH/day
337.60 NCH/day
168.75 NCH/day
150 NCH/day
768.75 NCH/day
3. Find the total number of nursing hours needed by patients per year
a. Total number of nursing hours per day x 365 days of the year
768.75 x NCH/day x 365 (days/year) = 280,593.75 NCH/year
4. Find the actual number of working hours rendered by each nursing personnel each year
a. Hours on duty per day x actual working days per year
8 (hrs/day) x 213 (working days/year) = 1,704 (workinghours/year)
5. Find the total number of nursing personnel needed
a. Divide the total number of nursing hours needed by the given number of patients per year by the actual number of working hours rendered per year
Total NCH/year = 280, 593.75 = 165
Working hrs/yr 1,704
5. Find the total number of nursing personnel needed
b. Find the relief, multiply the number of nursing personnel needed by .095
Relief x Total Nursing Personnel = 165 x 0.15 = 25
5. Find the total number of nursing personnel needed
c. Add number of relievers to the number of needed nursing personnel
Total Nursing Personnel = 165 + 25 = 190
6. Categorize into professional and non-professional
a. Multiply number of nursing personnel according to ration of professional to non-professional
190 x 0.65 = 124 professional nurses
190 x 0.35 = 66 nursing attendants
7. Distribute by shifts
124 nurses x 0.45 = 56 nurses on AM shift
124 nurses x 0.37 = 46 nurses on PM shift
124 nurses x 0.18 = 22 nurses on Night Shift
Total = 124 nurses
66 nursing attendants x 0.45 = 30 nursing attendants on AM shifts
66 nursing attendants x 0.37 = 24 nursing attendants on PM shifts
66 nursing attendants x 0.18 = 12 nursing attendants on Night shifts
Total = 66 nursing attendants
