Skilled Care and Budgeted Staffing Nursing Worksheet Solution 2

Skilled Care and Budgeted Staffing Nursing Worksheet

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Type	Essay
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Description/Paper Instructions

Skilled Care and Budgeted Staffing Nursing Worksheet

 

Consider this actual scenario (from my practice). You are a nurse manager of a 24-bed skilled nursing unit in a life-care community. The budgeting

staffing is:

 

Day Shift – 1 RN, 1 LPN, and 4 CNAs

 

Evening Shift – 1 RN, 1 LPN, and 4 CNAs

 

Night Shift – 1 RN, 2 CNAs

 

To achieve your budgeted staffing, your FTEs are as follows (all FT and PT staff work every other weekend):

 

RN = (3) 1.0 FTE and (3) .4 FTE

 

LPN = (2) 1.0 FTE and (2) .4 FTE

 

CNA = (10) 1.0 FTE and (10) .4 FTE

 

You are able to fill your RN and LPN positions, however, you have difficulty hiring part-time CNAs. You hire students to cover weekends and

experience nearly 100% turnover in 3-months. Subsequently, you have to hire agency CNAs at an increased cost and a negative impact on morale.

 

You learn that most CNAs work 2 full-time jobs to cover their expenses and call out quite frequently on both jobs. This practice increases the use

of agency and overtime, and has a terrible effect on resident and staff satisfaction. Though you provide all the staff with a regular schedule at

least 4 weeks in advance, the call-out rate for CNAs does not change.

 

You learn that your organization considers full-time as 60 hours biweekly (versus 80 hours). Employees scheduled (and work) at least 60 hours

biweekly receive full benefits including family healthcare and prorated time off based on the number of hours they work up to 80 hours biweekly.

 

Your goal is to a) meet budgeted staffing goals, b) eliminate agency, and c) implement self-coverage for unplanned absences (staff switch or

replace themselves with other staff without incurring overtime). What is your solution?

 

Patient Assessment & Health History Discussion

 

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned.

Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you

would ask the patient to build his or her health history and to assess his or her health risks.

 

Case study

 

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his

 

daughter, a single mother who has little time or money for her father’s health needs. He

 

has ahx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12

 

deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec

 

20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an

 

annual exam and states “I came for my annual physical exam, but do not want to be a

 

burden to my daughter.”

 

Skilled Care and Budgeted Staffing Nursing Worksheet

RUBRIC QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points:  Student failed to submit the final paper. 20 points out of 50:  The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50:  The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately.  Elements of the required response may also be lacking. 40 points out of 50:  The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples.  The answer is complete. 50 points:  The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples.  No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points:  Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points:  Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points:  References to scholarly sources are occasionally given; many statements seem unsubstantiated.  Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points:  Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented.  APA 6th Edition is used with only a few minor errors.  There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points:  Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented.  APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points:  Student failed to submit the final paper. 5 points out of 20:  The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors  10 points out 20:  The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20:  The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points:  The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points:  Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements.  The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper.
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