Question

Describe the various approaches in assessing the cost of nursing care

Examine the role of recruiting and retaining nurses in the cost of nursing care.

Explain the impact of nursing turnover on nursing care costs. Examine whether the cost assessment methods used in your organization are effective. Give reasons for your answer.

Essay style.

Answer 1

Question no:1

Various approaches in assessing cost of nursing care:

1. Cost- to- charge ratios:

1. It is a convenient tool for computing the cost of providing a service.
2. Cost- to- charge ratio is greater than one, which means the cost of operating these cost centers is greater than the charges.
3. They are 2 cost centers.
   1. Revenue- producing cost center- in which bills patients for services provided.
   2. Second type- overhead cost center, such as the accounting department, which exists to support the revenue- producing centers.

1. Cost benefit analysis:
   1. Is a planning technique that answers the following questions?
   2. The costs of purposing a goal, objective, a program, or a specific nursing interventions
   3. On what basis costs are compared with the benefits
   4. Comparison of different nursing interventions for the same nursing diagnosis or problem results in using the least costly interaction to achieve similar or better results.
   5. The intervention used will be a cost effective.
2. Cash budget:
   1. Is the actual operating budget in detail, usually excluding the capital budget?
   2. It indicates whether cash flow will be adequate to meet anticipated payments, debt obligations, including replacement and expansion of facilities.
   3. Unanticipated requirements, payroll, payment for supplies and services, and a prudent investment program.
3. Negative cash flow:
   1. Time lag between delivery of services and collection of payments.
   2. Labor expense (nursing salary) paid out in salary and wages does not cycle concurrently with collections.
   3. To maintain solvency, cash flow must be managed carefully and cycles of cash shortage planned appropriately.
4. Cost efficiency:
   1. It is concerned with the cost/ benefit ratio.
   2. Identification of impact of nursing care on the health of the patient, that is results or outcomes measured in terms of patient’s health status.
   3. A program practical enough to be used in all clinical nursing charges
   4. Nursing personnel who serve on committees long enough to be proficient
   5. Grading by each person administering criteria
   6. Interdisciplinary programs so nurses will not do the work of other disciplines.
   7. Planning for uncertain future by blueprinting scenarios for managing the future, changing the culture of nursing organizations, developing interpersonal skills, and making a creative response to risk taking.
   8. Each nurse should be held responsible for self-improvement and for delivering a high standard of patient care.
5. Customer satisfaction:
   1. Customer satisfaction is an integral part of QM
   2. Based on customer satisfaction nursing costs are also analyzed.

Question no:3

1. Nursing turnover is a biggest problem in health care organizations.
2. Nurse retention focuses on preventing nurse turnover and keeping nurses in an organization employment.
3. Several turn over costs classifications are as follows: direct or indirect, visible or invisible and pre- hire and post- hire.
4. Nursing turn over originate from both non-economic and economic sources.
5. Non- economic sources- concerns about the practicalities, retaining adequate numbers of RNs to appropriately provide safe care to patients, over- burdening existing staff with increased workloads and demands that may bring about more staff turnovers.
6. Nursing turnover costs are advertising and recruiting costs, orientation and training costs, deceased productivity, termination, potential patient errors, compromised quality of car, poor work environment and culture, dissatisfaction, distrust, loss of organizational culture, additional turnover.

Question no:2

1. Several benefits of nurse’s retention have been identified- patient safety and quality of care, patient satisfaction, nurse satisfaction and nurse safety.
2. Transforming the work environment by providing strong, top- level nursing leadership and supportive nursing supervision throughout organization, involving nurses in decision making related to patient care delivery and practice, re- designing nurses work spaces to be more ergonomic and less physically demanding; creating a culture of safety; limiting nurses work hours, ensuring safe staffing levels, offering flexible work schedules and employment opportunities such as job sharing and improving nurses wages.
3. Regarding retention costs:
   1. reduction in advertisement and recruitment costs

2. Fewer vacancies and reduction in vacancy costs

3. Fewer new hire and reduced in hiring costs

4. Fewer orienteers and reduced orientation and training costs

5. Maintained or increased productivity.

6. Fewer terminations and reduction in termination costs

7. Decreased patient errors and increased quality of care.

8. Improved work environment and culture, increased satisfaction, increased trust and accountability

9. Preserve organizational knowledge

10. Easier nurse recruitment.

Recruitment:

1. High vacancy rates increase the need for premium labor in organizations.
2. It will leads to patient admission loses and destabilize patient care systems with a potential increase in medical misadventures

Question no:4

1. To identify the feature of the efficiency and the effectiveness concepts
2. To explore the differences and proximities between effectiveness and efficiency.
3. Succeeds at minimum cost at which company thrives
4. Improving the nursing care, quality of care.
5. Cost effective analysis is very much benefitted by organization.