Norms are standards that guide, control, and regulate individuals and communities.

For planning nursing Manpower we have to follow some norms. The nursing norms are recommended by various committees, such as; the Nursing Man Power Committee, the High-power Committee, Dr. Bajaj Committee, and the staff inspection committee, TNAI and INC.

INDIAN NURSING
resources of the hospital,

COUNCIL

ownership of the hospital, type of the hospital and level of care it

provides, size of the hospital and community it serves, hours and pattern of work, type of building and premises plan, and other variables like level of technology, automation and research

Staffing Norms For Nursing Staff And Nursing Supervisors

Nursing Superintendent 1:1per hospital Dy. Nursing Supdt. 1 upto 400 beds Asstt. Nursing Supdt.

1 for every 200

beds Ward Sisters 1 for 100-150 beds

Cont..
Staff Nurse

1 nurse for 3 beds Teaching hospital1 nurse for 5 beds Non-teaching hospital1 nurse for 3 beds For ICU/CCU 1 nurse for 1 beds

Staffing Norms For Group-D Employees

Category

manpower per

bed ratio
Hospital Attendant

Sanitation Attendant

1 per 10 beds 1 per 10 1 per 15

beds Security Guard beds

Staffing Norms For Hospital Laboratory Services

One laboratory personnel (inclusive of

supervisory staff) should perform about 800010000 tests per annum. If considerable automation has been introduced in the laboratory work, the manpower requirement should be worked out on the basis of 20000 tests per person per annum.

Cont..
The ratio between supervisory staff

and technical personnel i.e. Lab. Technician and Lab. Assistant should be1:4 The ratio of Lab. Support staff (Lab. Attendants) with technical staff should be 1:3

Staffing Norms For Blood Bank

One blood bank technician for

every 8000-10000investigations per annum. One technician for every 1500020000 preparations per annum for component preparations

Staffing Norms For Blood Bank

One blood bank technician for

every 8000-10000investigations per annum. One technician for every 1500020000 preparations per annum for component preparations

Staffing Norms For Radio Imaging Department

A radiographer should be able to do12-15 cases

in an hour. For every four radiographers there should be 1 technical assistant. One technical supervisor is required for 8 radiographers to supervise and execute radiographic work while maintaining high standard of quality

Staffing Norms For ECG Technicians

There should be one technician and one

machine for every 50 ECGs done daily in the OPD. For inpatients, there should be one technician and one machine for ECGs in each 20 hour shift Workload of cardiology accounts for 40% of total ECG workload in inpatient area, hence there should be separate ECG technician and machine for cardiology ward.

Staffing Norms For CSSD

Staffing norms for CSSD for 750-1000 bedded hospital
Category of staff
CSSD Supervisor/Manager

No. of personnel

1
1 4 6 6 30

Superintendent Asstt. Supervisor Tech. Assistant

CSSD Asstt.Grade-I/Sr.CSSD Operators

. CSSD Asstt.Grade-II/Jr.CSSD Operators CSSD Attendants

Staffing Norms For Laundry Personnel

Staffing norms for laundry deptt for 750-1000 bedded hospital Category of staff No. of personnel
Laundry Manager/Supervisor Asstt. Laundry Supervisor Laundry Clerk/LDC Laundry Operator Laundry Attendant

1 3 2 30 1

Cont..
Laundry Mechanic

2 One laundry operator for 30 beds. Average laundry load 3-4 kg of soiled linen per patient. Operation theatre laundry load 7-8 kg of linen per operation

Staffing Norms For Dietary Department

Staffing Norms for Dietary Department for 750-1000

bedded hospital

Category of staff

No. of personnel

Chief Dietician Asstt. Dietician Technical Dietician (Jr.Dietician) Clerk (LDC)

1 3 2 2 1

Store Keeper

Cont..
Steward/Floor Supervisor 2 Head Cook Cook 16 Cook Aid/Helper 16 Bearer 24 4

Cont..
Steward/Floor Supervisor 2 Head Cook Cook 16 Cook Aid/Helper 16 Bearer 24 4

The Nurse-patient Ratio as per INC

The norms are based on Hospital Beds. Chief Nursing Officer

:1 per 500 beds Nursing Superintendent :1 per 400 beds or above D.NS. :1 per 300 beds and 1 additional for every 200 beds A.N.S. :1 for 100-150 beds or 3-4 wards Ward Sister :1 for 25-30 beds or one ward.

Cont
Staff Nurse :1 for 3 beds in Teaching Hospital in general ward& 1 for 5 beds in Non-teaching Hospital +30% Leave reserve Extra Nursing staff to be provided for departmental research function. For OPD and Emergency :1 staff nurse for 100 patients (1 : 100 ) + 30% leave reserve For Intensive Care unit: (I.C.U.)- 1:l or (1:3 for each shift ) +30% leave reserve. It is suggested that for 250 beded hospital there should be One Infection Control Nurse (ICN).

Patient classification system.

The three basic type of patient classification systems are 1.Narrative description 2.Check list 3.Time standard

NARRATIVE DESCRIPTION
Category one may be self care and category 4 complete care including feeding, frequent skin care, complete bathing ,complete bed rest, and frequent positioning.

CHECK LIST
The check-list type acuteness table divides elements of care routines into activity categories, such as eating and bathing . Activity levels are described in each category levels in eating category might be self care, help setting up ,feeding and frequent feeding. each activity is assigned an activity level point score such as 1 for routine care or self care and 4 for comprehensive care.

TIME STANDARD

A time standard or relative value unit ,system assign a value unit to varies activities of patient care these activities are usually clustered according to categories such as diet ,bathing, and mobility.

Medicus patient classification system

It clusters patients in to 5 categories with 5 indicating the greatest intensity of care. I t reflect both direct and indirect care.

GRASP(Grace Reynolds Application and Study of PETO)

It identifies about 50 direct and indirect

patient care activities. Time studies are performed to validate that the time estimates are accurate for the given organization.

The therapeutic intervention scoring system (TISS)

This is done by classifying numerous

conditions treatments in to categories assigned 1,2,3,or 4 points. The points are then summed to yield one of 4 classification.class1 fewer than 10 points.class-2 10-19 points.class-3 20-39 points.class-4 more than 40 points.

The experts Nurse Estimation patient classification system.(ENEPCES)

It identifies unique patient characteristics

in 8 categories.1.cognitive status 2. Selfcare status 3.emotional and psychosocial support needs.4.comfort/pain management needs 5 .family information and support needs 6 .treatment needs 7.interdeciplinary co-ordination and patient teaching.8 .transition needs

Matrix system:
Censes may be recorded as the number of patients down the left hand column. then there may be columns for the number of licensed staff(RNs, LPNs)and unlicensed staff or days and nights for 12-hrs shifts.

SIU
The Staff Inspection Unit was set up in 1964 with the object of effecting economy in manpower consistent with administrative efficiency and evolving performance standards and work norms in Government offices and Institutions wholly or substantially dependent on Government Grants. Its officers also serve as Core Member on the Committees appointed to scrutinize manpower requirements of Scientific and Technical Organizations.

NORMS OF STAFFING( S I U- staff inspection unit)

Recommendations of S.I.U: The norm has been recommended taking into account the workload projected in the wards and the other areas of the hospital. The posts of nursing sisters and staff nurses have been clubbed together for calculating the staff entitlement for performing nursing care work which the staff nurse will continue to perform even after she is promoted to the existing scale of nursing sister

CONT.
Out of the entitlement worked out on the

basis of the norms, 30%posts may be sanctioned as nursing sister. This would further improve the existing ratio of 1 nursing sister to 3.6. staff nurses The assistant nursing superintendent are recommended in the ratio of 1 ANS to every 4.5 nursing sisters

CONT.
The posts of Deputy Nursing Superintendent

may continue at the level of 1 DNS per every 7.5 ANS There will be a post of Nursing Superintendent for every hospital having 250 or beds. There will be a post of 1 Chief Nursing Officer for every hospital having 500 or more beds. It is recommended that 45% posts added for the area of 365 days working including 10% leave reserve

Bajaj committee ( 1985)

Formulation of National Medical & Health

Education Policy.
Formulation of National Health Manpower

Policy.
Establishment of an Educational Commission

for Health Sciences (ECHS) on the lines of UGC.

Cont.
Establishment of Health Science Universities in

various states and union territories.

Establishment of health manpower cells at centre

and in the states.

Vocationalisation of education at 10+2 levels as

regards health related fields with appropriate incentives, so that good quality paramedical personnel may be available in adequate numbers. Health man power survey.

HIGH POWER COMMITTEE

It was set up by the Govt. of India in July

1987,under the chairman ship of Dr. Jyothi ,former vice chancellor of SNDT women university, Mrs.Rajkumari Sood nursing advisor to union Govt. as the member secretory and CPB Kurup principal Govt. college of nursing Banglore. Later on due to some reasons the committee was headed by smt. Sarojini Varadappan ,former chairman of central social welfare board.

HIGH POWER COMMITTEE ON NURSING IN INDIA

Working conditions of nursing personnel Employment Job description Working hours Work load/ working facilities Pay and allowances Promotional opportunities Career development Accommodation

CONT.
Transport Special incentives Occupational hazards Other welfare services

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