1. Inpatient

1. Staffing is planned to be sufficient at all times to ensure that a Registered Nurse plans, supervises, and evaluates the care of all patients. There is a minimum of two licensed nurses on each unit at all times, one of whom is a Registered Nurse. A Care Delivery Facilitator (CDF) or Charge Nurse is assigned responsibility for the organization of the unit during an assigned shift (Care Delivery Facilitator - Addendum H.1). If at all possible, one nurse regularly employed on the unit is on duty at all times.
2. Nursing staff needs are based on the patient census and patient needs. (Patients will be classified according to the Quadramed system (Patient Classification System - Addendum H.2). Supplemental staffing may be utilized through the use of the internal float pool or alternate staffing assignments (Alternate Staffing Assignments - Addendum H.3). The needs of the patient and the expertise of the caregiver are assessed prior to assignments. When LPN's, Agency or Float Pool nurses are utilized, the CDF or Charge Nurse making patient care assignments retains responsibility for supporting and assisting them in patient care and other needs.
3. Staffing patterns and professional and nonprofessional ratios for each unit have been established based upon patient census and average acuity. The CDF or Charge Nurse in conjunction with CSM and or Director/ADON evaluates the predetermined staffing patterns on a shift to shift basis in response to changing patient needs and staff competence.
4. Staff scheduling is accomplished by the CDF or Charge Nurse in cooperation with the Director and CSM using standards already defined for each unit. Work schedules are posted for a four-week period and may only be altered by designated persons (Time Schedules and Staffing - Addendum H.4) and based on unit needs. Based upon unit needs, alternate scheduling options may be utilized (Scheduling Options/Payroll Guidelines (RN/LPN Only) - Addendum H.5).
5. During times of staffing shortage, increased census or increased patient needs, overtime hours may be worked for overtime pay. With administrative approval, additional critical shift incentives may be paid to assure adequate staffing levels necessary to meet patient needs.  Inpatient & Outpatient Staff adheres to Time and Attendance System Policy. (Overtime - Addendum H.6) & Unapproved Absences - HR 2.02
6. Nurses from the Agency/Float/PRN are used to supplement staffing. Nurses from the Float Pool work a set schedule and can rotate within designated divisions. PRN nurses are utilized as necessary to provide staffing for clinical areas. PRN nurses are encouraged to work a minimum of one day per month to maintain competency. (Role of UAMS Float Pool, Mother's Hours, Pool Nurses - Addendum H.8 for further information).
7. In emergency or unusual circumstances, such as inclement weather, the Nursing Administrator on duty assesses the critical needs of each unit to determine department staffing (Inclement Weather - Addendum H.9).
8. Upon request from a patient or family member private duty nurses may be obtained from an approved agency. Nurses who function as private duty nurses may provide care but may not give or chart medications. Private duty nurses follow all policies/ procedures of UAMS. When private duty nurses are utilized, the RN retains responsibility for the care of the patient.
9. Patients requiring constant supervision and/or observation may be observed by a non-licensed sitter. A unit staff nurse is assigned to this patient and retains responsibility for the care of the patient (Sitters - Addendum H.10).
10. Clinical rotations of nursing students are an integral part of University Hospital. The instructor is responsible for the assignment and clinical experience of the student. Staff assists in providing learning experience for the student and retain responsibility for patient care (Students from UAMS College of Nursing Having Learning Experiences in University Hospital - Addendum H.11).
11. Special requests for time off, i.e., holiday or vacation must be submitted in writing to the Clinical Services Manager. The requests are considered on a first-come, first-serve basis and are granted based on the needs of the unit (Time Schedules and Staffing - Addendum H.4).
12. Employees may be granted official leave to participate in job-related activities (Official Leave/Continuing Education - Addendum H.13). On some occasions, reimbursement for part or all of an individual’s expenses may be provided.

2.       Outpatient

1. Staffing is planned to be sufficient at all times to ensure that a licensed nurse supervises and evaluates the care of all patients. Supplemental staffing may be utilized through the use of the internal pool services or designated agencies.
2. Staffing patterns for each clinic have been established within approved budget and are based upon patient visits per year and services offered at that clinic. Each clinic’s staffing pattern may be found in clinic specific policy.
3. During times of staffing shortage, increased census or increased patient needs, overtime hours may be worked for overtime pay (Overtime - Addendum H.6).
4. Supplemental staffing may be utilized through the use of the PRN Pool and approved agencies (Role of UAMS Float Pool, Mother's Hours, Pool Nurses - Addendum H.8).
5. In emergency or unusual circumstances, such as inclement weather, the Clinic Managers or their designees will assess the critical needs of each clinic to determine staffing (Inclement Weather - Addendum H.9).
6. Clinical rotations of nursing students are an integral part of the UAMS campus. The instructor is responsible for the assignment of students to the various clinics. The clinical staff assists in providing learning experiences for the student but retain responsibility for the patient care (Students from UAMS College of Nursing Having Learning Experiences in University Hospital - Addendum H.11).
7. Employees of the clinics may be granted official leave to participate in job related activities (Official Leave/Continuing Education - Addendum H.13).

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