HCQ-3, Daily Patient Care Staffing, Inpatient - New Jersey
New Jersey Department of Health
DAILY PATIENT CARE STAFFING: INPATIENT UNITS
|REPORT FOR | |
| |(Date) |
NOTICE TO CONSUMER
N.J.S.A. 26:2H-5f through 5h (P.L. 2005, c. 21) requires hospitals to post information about staffing and patient-to-staff ratios for the previous shift. Summary reports on staffing for each hospital will be available on the New Jersey Department of Health website at health/healthcarequality.
|Name of Hospital |
| |
|Name of Inpatient Unit |
| |
|Unit Type (Check only one) |
|Medical-Surgical Normal Newborn Nursery Adult Open Psychiatric |
|Intermediate Care Neonatal Intensive Bassinets Adult Closed Psychiatric |
|Adult Intensive Care Unit/ Neonatal Intermediate Bassinets Child/Adolescent Open Psychiatric |
|Critical Care Unit Pediatrics Child/Adolescent Closed Psychiatric |
|Obstetrics (Post Partum) Pediatric Intensive Care Unit Substance Abuse |
|8-Hour Shift (Day, Evening and Night) |
|Shift |Number of |Staff Type |Actual Hours Worked|Number of Staff |Staff to Patient Ratio |
| |Patients | | | | |
|DAY | |Registered Professional Nurses |___.___ | RNs |1 RN: ___.___ Patients |
| | |Licensed Practical Nurses |___.___ | LPNs |1 LPN: ___.___ Patients |
| | |Unlicensed Assistive Personnel |___.___ | UAPs |1 UAP: ___.___ Patients |
|EVE. | |Registered Professional Nurses |___.___ | RNs |1 RN: ___.___ Patients |
| | |Licensed Practical Nurses |___.___ | LPNs |1 LPN: ___.___ Patients |
| | |Unlicensed Assistive Personnel |___.___ | UAPs |1 UAP: ___.___ Patients |
|NIGHT | |Registered Professional Nurses |___.___ | RNs |1 RN: ___.___ Patients |
| | |Licensed Practical Nurses |___.___ | LPNs |1 LPN: ___.___ Patients |
| | |Unlicensed Assistive Personnel |___.___ | UAPs |1 UAP: ___.___ Patients |
|12-Hour Shift (Day and Night) |
|Shift |Number of |Staff Type |Actual Hours Worked|Number of Staff |Staff to Patient Ratio |
| |Patients | | | | |
|DAY | |Registered Professional Nurses |___.___ | RNs |1 RN: ___.___ Patients |
| | |Licensed Practical Nurses |___.___ | LPNs |1 LPN: ___.___ Patients |
| | |Unlicensed Assistive Personnel |___.___ | UAPs |1 UAP: ___.___ Patients |
|NIGHT | |Registered Professional Nurses |___.___ | RNs |1 RN: ___.___ Patients |
| | |Licensed Practical Nurses |___.___ | LPNs |1 LPN: ___.___ Patients |
| | |Unlicensed Assistive Personnel |___.___ | UAPs |1 UAP: ___.___ Patients |
|Information on the daily, hospital-wide number of |Description of methods used to determine and adjust direct patient care staffing levels: |
|respiratory therapists and physical therapists is | |
|posted at: | |
| | |
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