A Budget In The Neonatal Intensive Care Unit

How to Create a Budget in the Neonatal Intensive Care Unit
Budget planning involves making predictions for the next year’s volume, revenue, and expenses (Penner,2013). A large portion of planning a budget includes taking a close look at the overall revenue, costs, and expenses of an organization. Nurse managers foster employee engagement that promotes workforce stability and job satisfaction. This stability and satisfaction builds the needed experience and expertise to improve patient care quality and safety (Parry, 2012). In most facilities, nurse managers help manage the operational budget which includes the medical expenses, non-medical expenses and other cost. To gain more insight on how to develop a budget, I interviewed a nurse manager

Acuity tools are used to decide staffing patterns for oncoming shifts, document patient acuity and historical staffing trends, and determine staff mixing models (Tazbir & Wicklein, 2014). The relationship between budgeting and staffing can be explained by using the term, hours per patient day (HPPD). When developing a budget, the nurse manager has to look at the patient census to determine if there are enough patients to bring in the revenue needed to cover nursing staff salaries. If there are not enough patients, nurse managers may be forced to send nurses home early or cancel shifts. In my interview with J.G. she stated our current census was 81 patients with HPPD at 17.25 (J.G., personal communication, September 8, 2016). Another correlation between budgeting and staffing includes the number of full-time, part-time and agency staff members. Full-time employees work more hours therefore they take up a large portion of the staffing budget. Agency workers are typically hired in from a staffing agency and their wages are higher, therefore using more of the staff budget. The qualifications, competencies, credentials, and experience of the staff also affect the number and type of staff required on any particular shift (Tazbir & Wicklein, 2014). J.G. stated nurse managers look at the experience level of the staff, the credentials such as advanced practice nurses, registered nurses, licensed practical nurses, and

Most intensive care units staff their high acuity patients, one nurse per two patients. The same policy applies to Neonatal Intensive Care Units (NICU). The guidelines specify ranges of nurse to patient ratios across infant acuity levels, as well as requisite nurse training and experience. For instance, infants with the lowest acuity levels have a recommended nurse to patient ratio of 1 to 3 or 4. In contrast, the highest acuity infants have recommended ratios of 1 or more nurses per patient (Rogowski et al, 2013). Because our patients are critically ill and require so much attention, I believe our unit should consider staffing more patient care technicians (PCTs). Currently there are 3-4 PCTs for our 100-bed NICU. To increase patient and parent satisfaction I would implicate a policy requiring a one PCT per 6-8 patients. I believe this will keep the nurse at the bedside, instead of leaving their area to gather supplies. Substantial NICU nurse understaffing relative to national guidelines is widespread. Understaffing is associated with an increased risk for VLBW (very low birth weight) nosocomial infection (Rogowski et al,