Assignment: Calculating NHPPD
Were the previous calculation exercises easy for you to complete? Great!! The next few are just as easy, but they begin to combine the elements of required nursing hours per patient day and the unit’s FTE requirements. But, before we get to that, you need to know how to derive the NHPPD and its related components.
Let’s get started!
The numbers of FTEs allocated to a nursing unit are based upon the NHPPD for that particular unit’s patient population and acuity. A variety of sources are available to compare your unit’s NHPPD with other units. In many cases there are national nursing standards that can be used as comparative data (like units, with the same type of patient population, are compared to each other). These units with the same or similar patient types usually have common nursing care requirements. When this is true, those nursing unit’s NHPPD are averaged to create a standard NHPPD. This number can only be used as a guide to determine the NHPPD for your unit, because differences such as geography, nursing care delivery system, support services available, and other variables may not be accounted for.
Why is it important for RNs to understand the concept of NHPPD and know their unit’s hours? Simply put, NHPPD defines how much nursing care each patient on the unit requires in a 24-hour period. In a sense, it defines the level of care required. Without it, the staffing might be based upon volume, rather than patient needs, and nursing care in acute care units should be based upon the needs of the patient.
In one example, a total of 103 shifts were worked by the distribution of staff given for one week. For a particular week, this unit experienced 85 patient days. From this data, one can calculate the NHPPD:
· NHPPD = Total shifts per week x 8 hours per shift
Number of Patient Days
NHPPD = 103 x 8 = 9.69
85
Now, here is one for you to figure out. Please calculate the NHPPD for the following unit, using Excel formulas to complete your calculations:
Unit 3A has had 61 patient days in the past week, with a total of 98 shifts staffed. What was 3A’s NHPPD for that time period?
NHPPD* = ___________________________________
*Format NHPPD to 2 decimal places.
As we said earlier, NHPPD is a compilation of different types of hours, one of which is Variable Hours of Care or Caregiver Hours. Remember, variable hours of care delineates those hours of care that are directly provided to the patient by a caregiver, defined as the RN, LVN, or nurse aide. Calculating Caregiver Hours gives us how many hours within the NHPPD are spent providing direct nursing care. It is calculated:
· Caregiver Hours = Total shifts of RNs, LVNs, & NAs x 8 hours per shift
Patient Days
In one example, the total shifts calculated = 103. There were 12 non-caregiver shifts (NM and US), which leaves 91 Caregiver shifts. Assuming the same number of patient days (85) from above, calculate the Caregiver Hours:
Caregiver Hours = 91 x 8 = 8.56
85
Using the situation described previously for Unit 3A, calculate the Caregiver Hours where there were 54 RN shifts, 14 LVN shifts, and 13 NA shifts. Use formulas in Excel for your calculations.
Caregiver Hours* = __________________________
*Format the Variable Hours of Care (Caregiver Hours) calculation to 2 decimal places.
We hope that you noticed that your Variable Hours of Care did not equal the number you got for NHPPD. Great!! That is because we have not taken into account yet the Fixed Hours. Fixed Hours of Care are the hours required for indirect care for every patient on a unit. Fixed hours are comprised of the secretarial work, management of the unit, and non-direct patient care (e.g. patient teaching done by a CNS). Remember, this number is constant, since it is not affected by acuity or volume.
· Fixed Hours of Care = Total shifts of NM, US, etc x 8 hours per shift
Patient Days
From our first example, calculate the number of shifts worked by the NM and US. Using the same patient days of 85, calculate Fixed Hours of Care for this unit:
Fixed Hours of Care = 12 x 8 = 1.13
85
Are you ready? Using the same situation for 3A and knowing that there are 5 Nurse Manager shifts, 5 CNS shifts, and 7 Unit Secretary shifts, calculate the Fixed Hours of Care: Again, use formulas in Excel to complete your calculations.
Fixed Hours of Care* = ______________________
*Format calculation to 2 decimal places.
Hopefully, when you add your answers for the Caregiver Hours and Fixed Hours of Care, you came up with the answer you originally got for your NHPPD. Remember, this occurs because NHPPD is a combination of Variable (Caregiver) Hours and Fixed Hours of Care.
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