university of regina carmeli

8/9/2019 University of Regina Carmeli

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UNIVERSITY OF REGINA CARMELIUNIVERSITY OF REGINA CARMELI

City of MalolosCity of Malolos

Graduate School DepartmentGraduate School Department

ACTION RESEARCHACTION RESEARCH

UNDERSTAFFING IN A SECONDARYUNDERSTAFFING IN A SECONDARYHOSPITALHOSPITAL

Submitted to:Submitted to:DR. AMELIA STA MARIADR. AMELIA STA MARIA

Professor Community Health Nursing, URC MalolosProfessor Community Health Nursing, URC Malolos

Submitted by:Submitted by:BENEDICTOS, RinalynBENEDICTOS, Rinalyn

CACHO, Joana MarieCACHO, Joana Marie

CANGCO, PaulaCANGCO, Paula

CASABUENA, MyraCASABUENA, Myra

De JESUS, Charish RoseDe JESUS, Charish Rose

DELA CUEVA, DianaDELA CUEVA, Diana

GASPAR, JaymillineGASPAR, Jaymilline

SANTIAGO, PolymarSANTIAGO, Polymar

Research TeamResearch Team


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I. INTRODUCTIONI. INTRODUCTION

Staffing is the process of determining & providing the acceptable number & mix ofStaffing is the process of determining & providing the acceptable number & mix of

nursing personnel to produce a desired level of care to meet the patients demands.nursing personnel to produce a desired level of care to meet the patients demands.

The purpose of all staffing activities is to provide each nursing unit with an appropriate &The purpose of all staffing activities is to provide each nursing unit with an appropriate &

acceptable number of workers in each category to perform the nursing tasks required.acceptable number of workers in each category to perform the nursing tasks required.

Too few or an improper mixture of nursing personnel will adversely affect the quality &Too few or an improper mixture of nursing personnel will adversely affect the quality &

quantity of healthcare services delivered. This is attested by the previous studies done byquantity of healthcare services delivered. This is attested by the previous studies done by

University of Pennsylvania, School of Nursing Study. It revealed that there is a clear linkUniversity of Pennsylvania, School of Nursing Study. It revealed that there is a clear link

between overworked nurses, staffing shortages & quality of patient care. According to thebetween overworked nurses, staffing shortages & quality of patient care. According to the

study, approximately 20,000 people die each year because they checked into hospitalsstudy, approximately 20,000 people die each year because they checked into hospitals with overworked nurses & understaffed hospitals. The study also found that people has awith overworked nurses & understaffed hospitals. The study also found that people has a

31 percent risk of dying if they are admitted to a hospital with a severe shortage of31 percent risk of dying if they are admitted to a hospital with a severe shortage of

nurses.(nurses.(http://www.afge.orghttp://www.afge.org))

Similar study had also showed same factual data regarding the relationship ofSimilar study had also showed same factual data regarding the relationship of

overworked nurses with direct patient care. According to the latest medical & nursingoverworked nurses with direct patient care. According to the latest medical & nursing

research conducted by the Journal of the American Medical Association (JAMA), theresearch conducted by the Journal of the American Medical Association (JAMA), the

most important factor determining the safety of hospitalized patients is the ratio ofmost important factor determining the safety of hospitalized patients is the ratio of

healthcare professionals attending to each patient (nurse to patient ratios). The studyhealthcare professionals attending to each patient (nurse to patient ratios). The study

found that each additional patient above four (4) that a nurse is caring for in a typicalfound that each additional patient above four (4) that a nurse is caring for in a typical

ward produces a 7 percent increase in mortality. As to the cost of providing appropriateward produces a 7 percent increase in mortality. As to the cost of providing appropriate

staffing in hospitals, studies conducted in California and reported in the New Englandstaffing in hospitals, studies conducted in California and reported in the New England

Journal of Medicine, show that the average hospital will experience only a 1 percentJournal of Medicine, show that the average hospital will experience only a 1 percent

increase in operating costs if ratios are introduced. (increase in operating costs if ratios are introduced. (http://www.capeannweb.comhttp://www.capeannweb.com))

Ideally, the Department of Health recommends a specific Hospital Staffing Formula toIdeally, the Department of Health recommends a specific Hospital Staffing Formula to

calculate the manpower needed in a specific in- patient units of the hospital. It iscalculate the manpower needed in a specific in- patient units of the hospital. It is

determined by the total number of bed capacity that can accommodate confined patients.determined by the total number of bed capacity that can accommodate confined patients.
http://www.afge.org/http://www.afge.org/http://www.afge.org/http://www.capeannweb.com/http://www.capeannweb.com/http://www.capeannweb.com/http://www.afge.org/http://www.capeannweb.com/


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Indeed, putting up a new hospital is tedious & difficult because it entails a lot ofIndeed, putting up a new hospital is tedious & difficult because it entails a lot of

problems. One of which is staffing & manpower allocation. Kairos Maternity & Generalproblems. One of which is staffing & manpower allocation. Kairos Maternity & General

Hospital, being a secondary hospital that is only in four (4) months of operation has alsoHospital, being a secondary hospital that is only in four (4) months of operation has also

its set of problems, among them is staffing. It has been noticed that there is only oneits set of problems, among them is staffing. It has been noticed that there is only one

Registered Nurse that is assigned to a 12- hour shift in a ward, without the aid of anyRegistered Nurse that is assigned to a 12- hour shift in a ward, without the aid of any

nursing attendants & midwives. In contrast with the Department of Health Standards thatnursing attendants & midwives. In contrast with the Department of Health Standards that

there should be atleast 2 nurses per 12- hour shift with 1 reliever & ancillary heathcarethere should be atleast 2 nurses per 12- hour shift with 1 reliever & ancillary heathcare

personnel (nursing attendants or midwives) in a ward given the fact that they are personnel (nursing attendants or midwives) in a ward given the fact that they are

classified as a Secondary level hospital.classified as a Secondary level hospital.

With these substantial data, the researchers consider that it would be very essential toWith these substantial data, the researchers consider that it would be very essential to

address this specific crisis so that future problems with regards to execution of healthcareaddress this specific crisis so that future problems with regards to execution of healthcare

services maybe avoided.services maybe avoided.


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II. BACKGROUND/ OBJECTIVES OF THE STUDYII. BACKGROUND/ OBJECTIVES OF THE STUDY

KAIROS MATERNITY AND GENERAL HOSPITAL is a secondary general hospitalKAIROS MATERNITY AND GENERAL HOSPITAL is a secondary general hospital

located in Muzon, San Jose Del Monte City, Bulacan. KAIROS was a named suggestedlocated in Muzon, San Jose Del Monte City, Bulacan. KAIROS was a named suggestedby Rev. Fr. Emmanuel I. Curz. It is a Greek word which meansGods gift in Gods timeby Rev. Fr. Emmanuel I. Curz. It is a Greek word which meansGods gift in Gods time

it started a small family clinic on July 25, 1999 about 25 meters away from its presentit started a small family clinic on July 25, 1999 about 25 meters away from its present

location. It has a branch in Poblacion, Meycauyan, Bulacan which started its operation onlocation. It has a branch in Poblacion, Meycauyan, Bulacan which started its operation on

May 8, 2000. The hospitals construction started on January 15, 2006 and was finallyMay 8, 2000. The hospitals construction started on January 15, 2006 and was finally

patient-focused health care that is accessible and affordable medical care to the patientspatient-focused health care that is accessible and affordable medical care to the patients

of San Jose Del Monte City and its neighboring towns. The vision of this institution isof San Jose Del Monte City and its neighboring towns. The vision of this institution is

To be a provider of high quality patient-focused health care that is dedicated to theTo be a provider of high quality patient-focused health care that is dedicated to the

administration of excellent, affordable and cost effective, and meets the needs of theadministration of excellent, affordable and cost effective, and meets the needs of the

people and communities we serve. Considering its vision, the institution aims to be:people and communities we serve. Considering its vision, the institution aims to be:

First, to be the best place for the patients to receive efficient, excellent and affordableFirst, to be the best place for the patients to receive efficient, excellent and affordable

medical care; second, to be the best place for the doctors to practice medicine and sharemedical care; second, to be the best place for the doctors to practice medicine and share

their expertise; and third, to be the place for its entire staff to work and serve thetheir expertise; and third, to be the place for its entire staff to work and serve the

community. The institution is guided by its core values such a KNOWLEDGE- staff shallcommunity. The institution is guided by its core values such a KNOWLEDGE- staff shall

provide the best skills and standards of care set by our profession, irrespective of ourprovide the best skills and standards of care set by our profession, irrespective of our

patients race, religion and beliefs; AFFORDABILITY/ ACCESSIBILITY- staff shallpatients race, religion and beliefs; AFFORDABILITY/ ACCESSIBILITY- staff shall

strive to provide affordable and accessible health care to everyone in the communitystrive to provide affordable and accessible health care to everyone in the community

while preserving our commitment of giving quality service; INTEGRITY- staff shallwhile preserving our commitment of giving quality service; INTEGRITY- staff shall

communicate openly and honestly, maintain our loyalty in this institution and build trustcommunicate openly and honestly, maintain our loyalty in this institution and build trust

and conduct ourselves in accordance with the highest ethical standards of our profession;and conduct ourselves in accordance with the highest ethical standards of our profession;

RESPECT- staff shall respect each individual, those we work with the highestRESPECT- staff shall respect each individual, those we work with the highest

professionalism and dignity; OBLIGATION- staff has our obligation to do our best in allprofessionalism and dignity; OBLIGATION- staff has our obligation to do our best in all

endeavors, to God who guide us in our tasks and to our patients who expect the best in usendeavors, to God who guide us in our tasks and to our patients who expect the best in us

for their health care; and SERVICE- staff shall strive to anticipate and meet the needs offor their health care; and SERVICE- staff shall strive to anticipate and meet the needs of

our patients, physicians, and co-workers.our patients, physicians, and co-workers.

KAIROS MATERNITY AND GENERAL HOSPITAL is a 36 bed capacity secondaryKAIROS MATERNITY AND GENERAL HOSPITAL is a 36 bed capacity secondary

hospital. It caters to private patients in the following departments and respective units:hospital. It caters to private patients in the following departments and respective units:


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GROUND FLOOR- Emergency Room, Pharmacy, Business Office, Laboratory,GROUND FLOOR- Emergency Room, Pharmacy, Business Office, Laboratory,

Radiology (X-ray and mammography), Ultrasound, Out-patient Department, and Chapel;Radiology (X-ray and mammography), Ultrasound, Out-patient Department, and Chapel;

SECOND FLOOR- Operating room, Delivery Room, Nursery, Central Supply Room,SECOND FLOOR- Operating room, Delivery Room, Nursery, Central Supply Room,

Suite and Private Rooms, Pediatric Ward; THIRD FLOOR- Obstetrics and GynecologySuite and Private Rooms, Pediatric Ward; THIRD FLOOR- Obstetrics and Gynecology

Ward, Female and Male Ward, Suite and Private Rooms; and BASEMENT- Office of theWard, Female and Male Ward, Suite and Private Rooms; and BASEMENT- Office of the

Chief Nurse, Electrical Room, Doctors Quarters, Male and Female Dorms, Guest Room,Chief Nurse, Electrical Room, Doctors Quarters, Male and Female Dorms, Guest Room,

Dietary Department and Canteen. Presently, the hospital has 12 hours duty for nurses.Dietary Department and Canteen. Presently, the hospital has 12 hours duty for nurses.

The EMERGENCY ROOM is the front liner of the hospital where the acutely ill andThe EMERGENCY ROOM is the front liner of the hospital where the acutely ill and

emergency cases are treated and admitted. OPD cases also are catered in ER as long asemergency cases are treated and admitted. OPD cases also are catered in ER as long as

they have no Attending Physician to attend for their needs. It is well-equipped andthey have no Attending Physician to attend for their needs. It is well-equipped and

manned by the Resident-on-duty Doctors, 24 hrs a day. As of now, the hospital has sixmanned by the Resident-on-duty Doctors, 24 hrs a day. As of now, the hospital has six

ROD. There are six staff nurses in ER; two nurses every 12 hour shift. An ambulanceROD. There are six staff nurses in ER; two nurses every 12 hour shift. An ambulance

with MOA from the Barangay is always on standby to transport to other health facilitieswith MOA from the Barangay is always on standby to transport to other health facilities

if necessary.if necessary.

The OUTPATIENT DEPARTMENT is where patients are seen and attended to byThe OUTPATIENT DEPARTMENT is where patients are seen and attended to by

consultants in Pediatrics, Internal Medicine, Surgery, Ophthalmology, ENT, Obstetricsconsultants in Pediatrics, Internal Medicine, Surgery, Ophthalmology, ENT, Obstetrics

and Gynecology. There are 2 personnel, midwives or nursing graduate assign everydayand Gynecology. There are 2 personnel, midwives or nursing graduate assign everyday

from7am to 5pm, Mondays to Sundays.from7am to 5pm, Mondays to Sundays.

The RADIOLOGICAL DEPARTMENT operates diagnostic radiology units,The RADIOLOGICAL DEPARTMENT operates diagnostic radiology units,

mammography, ultrasound and 2D echo. The department has two radiologists with a 24mammography, ultrasound and 2D echo. The department has two radiologists with a 24

hours duty.hours duty.

The CLINICAL LABORATORY is equipped with modern laboratory diagnosticThe CLINICAL LABORATORY is equipped with modern laboratory diagnostic

facilities capable of performing routine laboratory and blood chemistries. The Laboratoryfacilities capable of performing routine laboratory and blood chemistries. The Laboratory

consists of 4 Medical technologies, with 12 hours duty.consists of 4 Medical technologies, with 12 hours duty.

The OR-DR COMPLEX has two operating rooms, one delivery room and recovery room.The OR-DR COMPLEX has two operating rooms, one delivery room and recovery room.

Each operating room is complete with anesthesia and suction machines. AnEach operating room is complete with anesthesia and suction machines. An

electrosurgical unit is also available. There are male and female dressing rooms and oneelectrosurgical unit is also available. There are male and female dressing rooms and one


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doctors lounge. There are three fix staff nurses assigned in DR and one nurse and twodoctors lounge. There are three fix staff nurses assigned in DR and one nurse and two

midwives in OR. One staff in every 12 hour shift.midwives in OR. One staff in every 12 hour shift.

The NURSERY has a Pathological area with two incubators, a breastfeeding area and aThe NURSERY has a Pathological area with two incubators, a breastfeeding area and a

well-baby area with 8 bassinets. The nurse assigned in this area is also the DR Nurse.well-baby area with 8 bassinets. The nurse assigned in this area is also the DR Nurse.

The NURSES STATION I compose of 12 Bed Capacity which caters pediatric ward withThe NURSES STATION I compose of 12 Bed Capacity which caters pediatric ward with

8 beds, then 3 private ward and 1 suit room. It is manned by one nurse in a 12 hour shift.8 beds, then 3 private ward and 1 suit room. It is manned by one nurse in a 12 hour shift.

There are three nurses that rotate in its station.There are three nurses that rotate in its station.

The NURSES STATION II is composed of 24 bed capacity. These include: Male ward (3The NURSES STATION II is composed of 24 bed capacity. These include: Male ward (3

beds), Female ward (4 beds), OB ward (6 bed), 1 suite room and 10 private rooms. Therebeds), Female ward (4 beds), OB ward (6 bed), 1 suite room and 10 private rooms. There

are also two fix staff nurse and a reliever being rotated in this ward, one nurse per shift.are also two fix staff nurse and a reliever being rotated in this ward, one nurse per shift.


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III. PROCEDURE / METHODOLOGYIII. PROCEDURE / METHODOLOGY

The researchers studied Understaffing in a Secondary Hospital. The total no. ofThe researchers studied Understaffing in a Secondary Hospital. The total no. of

respondents among staff nurses in the said institution is three while among admittedrespondents among staff nurses in the said institution is three while among admitted

patients is also three. In staff nurses, two came from Nurses Station II & the other one ispatients is also three. In staff nurses, two came from Nurses Station II & the other one is

a reliever. The participants varied in terms of Gender, Civil Status, Religion, Affiliation,a reliever. The participants varied in terms of Gender, Civil Status, Religion, Affiliation,

Highest Educational Attainment and Length of Hospital Service.Highest Educational Attainment and Length of Hospital Service.

In understaffing in a secondary hospital in Bulacan, the researchers made used of aIn understaffing in a secondary hospital in Bulacan, the researchers made used of a

questionnaire as an instrument. All throughout the study, the said tool will be employed.questionnaire as an instrument. All throughout the study, the said tool will be employed.

The questionnaire is divided into two parts. The first part contains the demographicThe questionnaire is divided into two parts. The first part contains the demographicprofile of the respondents. The second part deters the perceived lack of manpower to staffprofile of the respondents. The second part deters the perceived lack of manpower to staff

nurses in a secondary hospital and its effect in terms of psychological, social and physicalnurses in a secondary hospital and its effect in terms of psychological, social and physical

aspects. The respondents were asked to rate its level in accordance to the situations theyaspects. The respondents were asked to rate its level in accordance to the situations they

are experiencing brought about by lack of manpower.are experiencing brought about by lack of manpower.

The data gathered for the action research were tallied, tabulated, and treated statistically.The data gathered for the action research were tallied, tabulated, and treated statistically.

The frequency of respondents who checked off particular items wee computed. InThe frequency of respondents who checked off particular items wee computed. In

treating the data, the following formulas were used:treating the data, the following formulas were used:

Frequency and Percentage Distribution.Frequency and Percentage Distribution. The formula is:The formula is:

P =P = nn X 100X 100

NN

Where:Where:

P = Percentage (%)P = Percentage (%)

n = Number of responsesn = Number of responses

N = Number of respondentsN = Number of respondents

100 = Constant100 = Constant


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Mean.Mean. The formula is:The formula is:

X =X = x x

NN

Where:Where:

X = MeanX = Mean

= Summation = Summation

X = Number of respondentsX = Number of respondents

N = Total number of respondentsN = Total number of respondents

Average Weighted Mean.Average Weighted Mean. The formula is:The formula is:

AWM =AWM = f1w1 + f2w2 + f3w3 + f4w4f1w1 + f2w2 + f3w3 + f4w4

TfTf

Where:Where:

AWM = Average Weighted MeanAWM = Average Weighted Mean

fw = Weighted frequencyfw = Weighted frequency

Tf = Total frequencyTf = Total frequency

The most common scaling technique is the Likert scale, which consists of severalThe most common scaling technique is the Likert scale, which consists of several

declarative statements (or items) that express a viewpoint on a topic. Respondents aredeclarative statements (or items) that express a viewpoint on a topic. Respondents are

asked to indicate how much they agree or disagree with the statement.asked to indicate how much they agree or disagree with the statement.


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IV FINDINGS / ANALYSIS / INTERPRETATIONIV FINDINGS / ANALYSIS / INTERPRETATION

Table 1: Number of Patients Admitted in Nurse Station 2 (NS2)

Based on the line graph above, there is consistent increase in the number ofBased on the line graph above, there is consistent increase in the number of

admitted patients each month, once it started. Some prominent cases noted were theadmitted patients each month, once it started. Some prominent cases noted were the

following: dengue hemorrhagic fever, common flu, cardiac related diseases, and otherfollowing: dengue hemorrhagic fever, common flu, cardiac related diseases, and other

Obstetric cases since the institution is a maternity hospital.Obstetric cases since the institution is a maternity hospital.

With the onset of the rainy season, the Department of Health (DOH) pushed aWith the onset of the rainy season, the Department of Health (DOH) pushed a

campaign against dengue. Health Secretary Francisco Duque III said the number ofcampaign against dengue. Health Secretary Francisco Duque III said the number of

dengue cases is increasing but this should not lead the public into concern. Denguedengue cases is increasing but this should not lead the public into concern. Dengue

belongs to the so-called W.I.L.D. (Water-borne, Infectious, Leptospirosis, Dengue) belongs to the so-called W.I.L.D. (Water-borne, Infectious, Leptospirosis, Dengue)

diseases that the DOH wants the public to be concerned about. Duque added the WILDdiseases that the DOH wants the public to be concerned about. Duque added the WILD

diseases are easily preventable if only people will follow the advisories of the DOHdiseases are easily preventable if only people will follow the advisories of the DOH

issued on television, radio, newspaper and Internet via the DOH website. The DOH isissued on television, radio, newspaper and Internet via the DOH website. The DOH is

MonthNo. of

Patients

March 40

April 72

May 75

June 78

Number of Patients Admitted in Nurse

Station 2 (NS2)

0

20

40

60

80

100

March April May June

Month

No.

OfPatients

Admitted

Series1


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primarily advocating proper hand washing with soap and water. It also urged the publicprimarily advocating proper hand washing with soap and water. It also urged the public

to wear protective gear when it is raining and avoid wading in floodwaters. The mostto wear protective gear when it is raining and avoid wading in floodwaters. The most

important key to preventing and controlling diseases is empowering our people withimportant key to preventing and controlling diseases is empowering our people with

correct information so that they can take steps to stop their transmission and limit thecorrect information so that they can take steps to stop their transmission and limit the

harm they bring through proper and timely health-seeking behavior, he maintained. Fluharm they bring through proper and timely health-seeking behavior, he maintained. Flu

cases were also noted that were increased because of seasonal environment. Cardiaccases were also noted that were increased because of seasonal environment. Cardiac

related diseases are the number one mortality and morbidity cases in the Philippinesrelated diseases are the number one mortality and morbidity cases in the Philippines

recorded by the Department of Health.recorded by the Department of Health.


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PROFILE OF 3 STAFF NURSES IN THE FOLLOWING CATEGORYPROFILE OF 3 STAFF NURSES IN THE FOLLOWING CATEGORY

Table 2.1 Ages of Staff Nurses

Age RangeAge RangeNo. of StaffNo. of Staff

NursesNurses

20-30y/o20-30y/o 3331-40y/o31-40y/o 00

41-50y/o41-50y/o 00

The table shows that all staff nurses are in the range of 20-31 years old. It is because theThe table shows that all staff nurses are in the range of 20-31 years old. It is because the

hospital is newly established and the management believes that newly registered nurseshospital is newly established and the management believes that newly registered nurses

are more competent one.are more competent one.

Table 2.2 Gender of Staff NursesGender No. of StaffNo. of Staff

NursesNurses

Male 1

Female 2

The table shows that the majority of staff nurses are female in gender. Ward nursesThe table shows that the majority of staff nurses are female in gender. Ward nurses

mainly compose of female staffs while male staffs are in the special area like Emergencymainly compose of female staffs while male staffs are in the special area like Emergency

room and Intensive Care Units.room and Intensive Care Units.

Table 2.3 Marital Status of Staff Nurses

Marital Status No. of StaffNo. of Staff

NursesNurses

Single 3

Married 0

Live in 0

Widowed 0

The table shows that all staff nurses are single. It is because they are most likely at earlyThe table shows that all staff nurses are single. It is because they are most likely at early

age of their profession.age of their profession.

Table 2.4 Employment History of Staff Nurses


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Employment

History

No. of StaffNo. of Staff

NursesNurses

> 3 months 0

3-6 months 0

6-9 months 1

9-12 months 2

The table shows that two staff nurses have 9-12 months experience and one has 6-9The table shows that two staff nurses have 9-12 months experience and one has 6-9

months experience. The experienced they had usually a volunteer or trainee nurse.months experience. The experienced they had usually a volunteer or trainee nurse.

Table 2.5 Length of Stay of Staff Nurses

Length of Stay No. of StaffNo. of Staff

NursesNurses

1 month 0

2 months 0

3 months 2

4 months 1

5 months 0

The table shows that two staff nurses have a length of 3 months and one has 4 months.The table shows that two staff nurses have a length of 3 months and one has 4 months. The staff nurses serves as the pioneer in the hospital since the hospital starts its serve onThe staff nurses serves as the pioneer in the hospital since the hospital starts its serve on

the month of March.the month of March.

Table 2.6 Number of Patients in NS2 mostly handle by the Staff Nurses

Patient Number No. of StaffNo. of Staff

NursesNurses

1-3 0

4-6 0

7-9 2

10-12 1

13-15 0

16-18 0


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19-21 0

22-24 0

The table shows that two staffs mostly handle 7-9 patients per shift while one staffThe table shows that two staffs mostly handle 7-9 patients per shift while one staff

handles 10-12. Having 22 bed capacities Hospital, recommended nurses should be 5 plushandles 10-12. Having 22 bed capacities Hospital, recommended nurses should be 5 plus

1 reliever. The hospital is understaffed.1 reliever. The hospital is understaffed.

Table 3 Educational Attainment of Staff Nurses

Educational

Attainment

No. of StaffNo. of Staff

NursesNurses

RN 2

MAN/MSN 1

The table shows that two nurses are registered nurse while one nurse taking up the masterThe table shows that two nurses are registered nurse while one nurse taking up the master

degree. To be more competent nurse registered nurses engaged themselves in continuingdegree. To be more competent nurse registered nurses engaged themselves in continuing

education which are masters degree other certification like midwife and renal specialist.education which are masters degree other certification like midwife and renal specialist.

ANCILLARY HEALTH WORKERS

There are no ancillary health care workers in the institute. Ancillary health care workersThere are no ancillary health care workers in the institute. Ancillary health care workers

refer to the other allied health workers that is knowledgeable and skillful to the hospitalrefer to the other allied health workers that is knowledgeable and skillful to the hospital

setting which helps nurses and doctors maintain and restore patients health. They aresetting which helps nurses and doctors maintain and restore patients health. They are

midwives, nursing assistants and student nurses.midwives, nursing assistants and student nurses.

Table 4 Response of the Staff Nurses in the Questionnaire


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NO. 5 4 3 2 1 FX MEAN INTERPRETION1 1 1 1 6 2

2 3 3 1

2.1 3 3 1

2.2 3 3 13 2 1 14 4.666667

4 1 2 7 2.333333

5 3 6 2

6 3 9 3

7 3 12 4

Total 2.23 Fair

1 3 12 4

2 2 1 14 4.666667

3 1 2 13 4.333333

4 3 12 4

4.1 1 2 10 3.333333

4.2 3 12 44.3 1 2 10 3.333333

5 1 2 13 4.333333

6 3 9 3

7 3 3 1

7.1 3 3 1

7.2 3 6 2

Total 2.64 Fair

1 1 2 10 3.333333

2 3 12 4

3 2 1 11 3.666667

4 2 1 11 3.666667

5 3 9 36 3 9 3

7 1 2 10 3.333333

8 3 9 3

9 2 1 11 3.666667

total 3 Fair

Overalltotal 272 2.62 Fair


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As shown on the table, the overall weighted mean reveals that 3 respondents (staff nursesAs shown on the table, the overall weighted mean reveals that 3 respondents (staff nurses

in nurse station 2) have fair response to the job satisfaction rating.in nurse station 2) have fair response to the job satisfaction rating.

Shaver and Lacey (2003) found that when RNs feel short staffing interfered with theirShaver and Lacey (2003) found that when RNs feel short staffing interfered with their

ability to meet patients' needs; they were also less satisfied with their job. Kalliath andability to meet patients' needs; they were also less satisfied with their job. Kalliath and

Morris (2002) determined that job satisfaction was a significant predictor of burnout andMorris (2002) determined that job satisfaction was a significant predictor of burnout and

suggested that improving job satisfaction may be an antidote to burnout. Most recently,suggested that improving job satisfaction may be an antidote to burnout. Most recently,

Aiken, Clarke, and Sloane (2002) reported that nurse staffing patterns affect not onlyAiken, Clarke, and Sloane (2002) reported that nurse staffing patterns affect not only

patient mortality but also burnout and job dissatisfaction.patient mortality but also burnout and job dissatisfaction.

Patients Response to the Services of the Staff NursesPatients Response to the Services of the Staff Nurses

1. Bakit ninyo naisipan Magpaospital dito?

Figure 1


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0

0.5

1

1.5

2

2.5

maganda malinis nairekominda

Dahil ng pagpili sa Ospital

No.ofPatie

0

0.5

1

1.5

2

2.5

OO HINDI

0

0.2

0.4

0.6

0.8

1

1.2

Mabagalna

serbisyo

Hindipagtugon

sa

pangangailangan

ngpasyente

Kakulanganng

impormasyonsa

pasyente

Hindimaayosna

pakikitungong

Nars

As shown on Figure 1 Two among 3 respondentsAs shown on Figure 1 Two among 3 respondents

chose the institution based on recommendation ofchose the institution based on recommendation of

their immediate friends and relativestheir immediate friends and relatives.

2. Base sa inyong pamamalagi sa Ospital na ito, nagustuhan niyo po ba ang serbisyo2. Base sa inyong pamamalagi sa Ospital na ito, nagustuhan niyo po ba ang serbisyo

ng mga Nars?ng mga Nars?

Figure 2Figure 2

This figure revealed that most of the respondentsThis figure revealed that most of the respondents

were unsatisfied with their confinement at the saidwere unsatisfied with their confinement at the said

institution.institution.

3. Kung hind, ano ang mga karanasang hindi nagustuhan?

Figure 3

In connection with the data on Fig. 2 and Fig. 3,In connection with the data on Fig. 2 and Fig. 3,

revealed that most of the negative comments byrevealed that most of the negative comments by

the respondents were poor health education andthe respondents were poor health education and

slow execution of health care needs.slow execution of health care needs.

Computation of Staffing in NurseComputation of Staffing in Nurse

Station 2 with 22 bed capacityStation 2 with 22 bed capacity

1.1. Secondary HospitalSecondary Hospital

22 x .65 = 14.322 x .65 = 14.3

22 x .30 = 6.622 x .30 = 6.6

22 x .05 = 1.122 x .05 = 1.1

______________

2222


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2.2. 14.3 x 1.5 = 21.4514.3 x 1.5 = 21.45

6.6 x 3 = 19.86.6 x 3 = 19.8

1.1 x 4.5 = 4.951.1 x 4.5 = 4.95

____________

46.246.2

3. 46.2 x 365 days =46.2 x 365 days = 16863 hrs/yr16863 hrs/yr

4. 12 hrs x 265 =12 hrs x 265 = 31803180

5. 16863/ 3180 =16863/ 3180 = 5.30 staff nurses/day5.30 staff nurses/day

6. 5.30 x .12 = 0.64 /5.30 x .12 = 0.64 / 1 reliever1 reliever

5 staff nurses + 1 reliever

6 staff needed

In a secondary hospital, with 22 bed capacity nurse station 2, the recommendedIn a secondary hospital, with 22 bed capacity nurse station 2, the recommended

staff nurses are 5 with 1 reliever. Currently, the hospital has 2 staff nurses and 1 relieverstaff nurses are 5 with 1 reliever. Currently, the hospital has 2 staff nurses and 1 reliever

in the area.in the area.

Unfortunately, on a low level, insufficient staffing is causing a decrease in theUnfortunately, on a low level, insufficient staffing is causing a decrease in the

quality of health care. Because of under-staffing, nurses are unable to spend adequatequality of health care. Because of under-staffing, nurses are unable to spend adequate

time with each patient, which reduces attention to detail. This causes stress, whichtime with each patient, which reduces attention to detail. This causes stress, which

decreases levels of job satisfaction. Unhappiness is driving nurses out of a profession thatdecreases levels of job satisfaction. Unhappiness is driving nurses out of a profession that

is already experiencing a huge discrepancy in hiring. A study in the Journal of theis already experiencing a huge discrepancy in hiring. A study in the Journal of the

American Medical Association's October 2002 issue has stated that the nursing shortageAmerican Medical Association's October 2002 issue has stated that the nursing shortage

is causing "avoidable patient deaths." With the reduction in nursing hires, there isis causing "avoidable patient deaths." With the reduction in nursing hires, there is

lowered access to effective health care. Hospitals experience frequent nurse turnover,lowered access to effective health care. Hospitals experience frequent nurse turnover,

which lowers the consistency of care. The nursing shortage has allegedly causedwhich lowers the consistency of care. The nursing shortage has allegedly caused

problems in complication detection and communication between nurses.problems in complication detection and communication between nurses.


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V. RECOMMENDATIONS / RESOLUTIONS OF THEV. RECOMMENDATIONS / RESOLUTIONS OF THE

PROBLEMPROBLEM

The researchers had arrived at the conclusion that there is profound lack of manpower inThe researchers had arrived at the conclusion that there is profound lack of manpower in

Kairos Maternity & General Hospital. Pertinent data had been collected showing thatKairos Maternity & General Hospital. Pertinent data had been collected showing that

there is a need for additional healthcare workers to suffice the fast- growing number ofthere is a need for additional healthcare workers to suffice the fast- growing number of


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patients that they are handling (as seen on the line graph in chapter 4). Enumerated belowpatients that they are handling (as seen on the line graph in chapter 4). Enumerated below

are some of the projected solutions that may help the institution in dealing with theare some of the projected solutions that may help the institution in dealing with the

presently diagnosed problem.presently diagnosed problem.

1. Accommodation of Student nurses for affiliation.Accommodation of Student nurses for affiliation. The institution willThe institution will

explicitly benefit with this strategy because part of the workload shouldered byexplicitly benefit with this strategy because part of the workload shouldered by

staff nurses, specifically those who are assigned in the ward, will be lessened.staff nurses, specifically those who are assigned in the ward, will be lessened.

With the aid of student nurses, problems regarding manpower maybe solved.With the aid of student nurses, problems regarding manpower maybe solved.

Also, it will help the institution to collect substantial revenue that is veryAlso, it will help the institution to collect substantial revenue that is very

beneficial in a newly built hospital like Kairos Maternity & General Hospital.beneficial in a newly built hospital like Kairos Maternity & General Hospital.

2. Hiring of other ancillary health workers like midwives, nursingHiring of other ancillary health workers like midwives, nursing

attendants & caregivers.attendants & caregivers. The researchers perceived that the root cause why wardThe researchers perceived that the root cause why ward

nurses consider themselves overworked & exhausted is due to the fact that theynurses consider themselves overworked & exhausted is due to the fact that they

shoulder all of the nursing activities alone from the simple obtaining of patientsshoulder all of the nursing activities alone from the simple obtaining of patients

vital signs & requisition of medicines to the more complex nursing activities likevital signs & requisition of medicines to the more complex nursing activities like

drug administration. The hiring of ancillary health worker may help the warddrug administration. The hiring of ancillary health worker may help the ward

nurses by delegating basic healthcare activities to them, thus reducing the nursesnurses by delegating basic healthcare activities to them, thus reducing the nurses

workload. Although this strategy demands additional charge in the hospitalsworkload. Although this strategy demands additional charge in the hospitals

operating expenses, the salary of ancillary health worker is still cheaper ifoperating expenses, the salary of ancillary health worker is still cheaper if

compared to the basic salary of a regular nurse.compared to the basic salary of a regular nurse.

3. Accommodation of Volunteer Registered Nurses.Accommodation of Volunteer Registered Nurses. Given the fact thatGiven the fact that

Kairos Maternity & General Hospital is a newly built structure, The researchersKairos Maternity & General Hospital is a newly built structure, The researchers

know that the cost of hiring a regular staff nurse will be in question. We perceivedknow that the cost of hiring a regular staff nurse will be in question. We perceived

that since there are many unemployed registered nurses nowadays who seekthat since there are many unemployed registered nurses nowadays who seek

hospital experiences, the institution may take advantage on that part so thathospital experiences, the institution may take advantage on that part so that

manpower problem maybe resolved accordingly.manpower problem maybe resolved accordingly.

4. The combination of the abovementioned strategies.The combination of the abovementioned strategies. Truly, if theTruly, if the

circumstances may allow, the combination of the abovementioned strategies willcircumstances may allow, the combination of the abovementioned strategies will


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be advantageous to the institution. The accommodation of Volunteer Registeredbe advantageous to the institution. The accommodation of Volunteer Registered

Nurses & the affiliation of student nurses can already satisfy the manpowerNurses & the affiliation of student nurses can already satisfy the manpower

deficiency.deficiency.


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VI. APPENDICESVI. APPENDICES

university of regina carmeli

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