Summary of Staff Daily Activities According to Shift I.

Staff Nurses
A. Morning Shift (6:00am-2:00pm) with 3 staff nurses.

Summary was based on the activities written by eight (8) nurses who were assigned on 6:00am-2:00pm shift indicating the minimum length of time required for them to accomplish a nursing activity or procedure. Time frame of the study is from November 3 to November 8, 2011. Length of Time to Accomplish per nurse (minimum) 10 minutes 10-20 minutes 5-10 minutes 5-10 minutes 10 minutes 30-45 minutes

Activity (6:00am-2:00pm) Checking of the completeness of the E-Cart and other supplies Changing of Surgical instrument Packing of surgical instruments to be autoclaved. Checking of equipments Prayer/ Endorsement (Receiving endorsements) Housekeeping (dusting to include refilling of supplies) Triaging

5 minutes per patient 4 minutes (1 minute Vital signs taking per VS) Carrying-out of doctors orders/ Admitting Procedures (PER PATIENT) Requisition (pharmacy and ancillary services 3-5 minutes etc.) Retrieving requisitions (medicines and supplies 5-10 minutes from the Pharmacy Coordination with the Ancillary departments. 3-5 minutes Coordination with HMO approval hotlines (if with 15-20 minutes HMO) (depending on case and HMO protocol) Preparation Medication 3-5 minutes/ medicine Giving of Medications (oral) 1-3 minutes/ medicine Giving Medications (IV) 3-5 minutes/ medicine Giving Medication (Nebulization) 3-5 minutes/ medicine Giving Medication (IM, SQ) 3-5 minutes/ medicine Skin Testing 3-5 minutes/ medicine

Starting Oxygenation Foley Catheter insertion Straight Catheterization Preparing supplies for NGT insertion Assisting residents on duty in performing NGT insertion CBG taking I.V. insertion Starting I.V. Fluid/s /venoclysis Shifting I.V. Fluids Heplock insertion Assisting/ accompanying patients to X-Ray/ CT Scan/ ultrasound if close monitoring is needed. Assisting Surgery residents during minor surgical procedures. Preparation of Dressing Set Washing of used instruments Charting Following-up of Laboratory results Transporting patient Endorsing patient/s to receiving unit Housekeeping after shift Completion of the E-cart Endorsement (out-going) Logging/ transcribing data on time and motion sheet Assisting in a CODE (two nurses required) Gathering/ Preparation of all supplies/ equipment needed. Ambu-bagging Connecting patient to Cardiac Monitor and Pulse Oximeter CPR Starting I.V. Access Administration of Emergency drugs Suctioning Assisting resident during intubation Assisting residents during cardioversion/ defibrillation. Coordination with ancillary departments. Requisition of used medicines and supplies. Aftercare of all equipment and apparatus used. Postmortem Care Discharging Patients Prepares charges by transcribing on patients

1-3 minutes 15-20 minutes 15-20 minutes 3-5 minutes 15-20 minutes 3-5 minutes 10-15 minutes 3-5 minutes 5-10 minutes 10-20 minutes 15-20 minutes 3-5 minutes 5-10 minutes 5-10 minutes 3-5 minutes 3-5 minutes 5-10 minutes 10-20 minutes 10-15 minutes 10-15 minutes 10-15 minutes

Resuscitation procedure takes minimum of 4560minutes. Not including aftercare/ replacement of supplies/ coordination with ancillary department and postmortem.

3-5 minutes

chart and prepare charge slip to be issued by the ER encoder. Ushers patient or accompanying person to the ER information Assists patient out of bed; assists patients in riding wheelchair or ushering out of ER. Instructs patient or accompanying person regarding payment of charges (location of cashiers) Coordination with HMO for approval of services given

2-3 minutes 3-5 minutes 3-5 minutes 15-20 minutes

B. Afternoon Shift (2:00pm-10:00pm) with four (4) nurses on duty

Summary was based on the activities of six (6) staff nurses assigned on 2:00pm-10:00pm shift from November 3 to November 8, 2011. Activity (2:00pm-10:00pm) Checking of the completeness of the E-Cart and other supplies Prayer/ Endorsement (Receiving endorsements) Housekeeping (Changing of linens/ bed-making etc.) Triaging Length of Time to Accomplish per nurse (minimum) 10 minutes 10-15 minutes 5-10 minutes

5 minutes per patient 4 minutes (1 minute Vital signs taking per VS) Patients Registration (Role of Nurses) after Business Center closes. Assisting patients in filling-up the BIZBOX slip. 3-5 minutes Coordination with ancillary services for inquiries 3-5 minutes regarding procedures requested. Coordination with HMO approval hotlines (if with 15-20 minutes HMO) (depending on case and HMO protocol) Carrying-out of doctors orders/ Admitting Procedures (PER PATIENT) Requisition (pharmacy and ancillary services 3-5 minutes etc.) Retrieving requisitions (medicines and supplies 5-10 minutes from the Pharmacy Coordination with the Ancillary departments. 3-5 minutes

Coordination with HMO approval hotlines (if with 15-20 minutes HMO) (depending on case and HMO protocol) Preparation Medication 3-5 minutes/ medicine Giving of Medications (oral) 1-3 minutes/ medicine Giving Medications (IV) 3-5 minutes/ medicine Giving Medication (Nebulization) 3-5 minutes/ medicine Giving Medication (IM, SQ) 3-5 minutes/ medicine Skin Testing 3-5 minutes/ medicine Starting Oxygenation 1-3 minutes Foley Catheter insertion 15-20 minutes Straight Catheterization 15-20 minutes CBG taking 3-5 minutes I.V. insertion 10-15 minutes Starting I.V. Fluid/s /venoclysis Shifting I.V. Fluids 3-5 minutes Heplock insertion 5-10 minutes Assisting/ accompanying patients to X-Ray/ CT 10-20 minutes Scan/ ultrasound if close monitoring is needed. Assisting Surgery residents during minor 15-20 minutes surgical procedures. Preparation of Dressing Set 3-5 minutes Washing of used instruments 5-10 minutes Charting 5-10 minutes Following-up of Laboratory results 3-5 minutes Transporting patient 3-5 minutes Endorsing patient/s to receiving unit 5-10 minutes Housekeeping after shift 10-20 minutes Completion of the E-cart 10-15 minutes Endorsement (out-going) 10-15 minutes Logging/ transcribing data on time and motion 10-15 minutes sheet Assisting in a CODE (two nurses required) Gathering/ Preparation of all supplies/ equipment needed. Resuscitation procedure takes Ambu-bagging minimum of 45Connecting patient to Cardiac Monitor and Pulse 60minutes. Not Oximeter including CPR aftercare/ Starting I.V. Access replacement of Administration of Emergency drugs supplies/ Suctioning coordination Assisting resident during intubation with ancillary Assisting residents during cardioversion/ department and defibrillation.

Coordination with ancillary departments. Requisition of used medicines and supplies. Aftercare of all equipment and apparatus used. Postmortem Care Discharging Patients Prepares charges by transcribing on patients chart and prepare charge slip to be issued by the ER encoder. Ushers patient or accompanying person to the ER information Assists patient out of bed; assists patients in riding wheelchair or ushering out of ER. Instructs patient or accompanying person regarding payment of charges (location of cashiers) Coordination with HMO for approval of services given

postmortem.

3-5 minutes 2-3 minutes 3-5 minutes 3-5 minutes 15-20 minutes

C. Night Shift (10:00pm-6:00am) with three (3) nurses on duty. Summary was based on the activities of six (6) staff nurses assigned on 10:00pm- 6:00pm shift from November 3 to November 8, 2011. Activity (10:00pm-16:00pm) Length of Time to Accomplish per nurse (minimum)

Checking of the completeness of the E-Cart and 10 minutes other supplies Prayer/ Endorsement (Receiving endorsements) 10-15 minutes Triaging 5 minutes per patient 4 minutes (1 minute Vital signs taking per VS) Wash all injection trays, cotton canister, pick-up 15-20 minutes forceps, medicine glasses and other patients utensils. Carrying-out of doctors orders/ Admitting Procedures (PER PATIENT) Requisition (pharmacy and ancillary services 3-5 minutes etc.) Retrieving requisitions (medicines and supplies 5-10 minutes from the Pharmacy Coordination with the Ancillary departments. 3-5 minutes Coordination with HMO approval hotlines (if with 15-20 minutes

HMO) Preparation Medication Giving of Medications (oral) Giving Medications (IV) Giving Medication (Nebulization) Giving Medication (IM, SQ) Skin Testing Starting Oxygenation Foley Catheter insertion Straight Catheterization CBG taking I.V. insertion Starting I.V. Fluid/s /venoclysis Shifting I.V. Fluids Heplock insertion Assisting/ accompanying patients to X-Ray/ CT Scan/ ultrasound if close monitoring is needed. Assisting Surgery residents during minor surgical procedures. Preparation of Dressing Set Washing of used instruments Charting Following-up of Laboratory results Transporting patient Endorsing patient/s to receiving unit Housekeeping after shift Completion of the E-cart Endorsement (out-going) Logging/ transcribing data on time and motion sheet Assisting in a CODE (two nurses required) Gathering/ Preparation of all supplies/ equipment needed. Ambu-bagging Connecting patient to Cardiac Monitor and Pulse Oximeter CPR Starting I.V. Access Administration of Emergency drugs Suctioning Assisting resident during intubation Assisting residents during cardioversion/ defibrillation. Coordination with ancillary departments.

(depending on case and HMO protocol) 3-5 minutes/ medicine 1-3 minutes/ medicine 3-5 minutes/ medicine 3-5 minutes/ medicine 3-5 minutes/ medicine 3-5 minutes/ medicine 1-3 minutes 15-20 minutes 15-20 minutes 3-5 minutes 10-15 minutes 3-5 minutes 5-10 minutes 10-20 minutes 15-20 minutes 3-5 minutes 5-10 minutes 5-10 minutes 3-5 minutes 3-5 minutes 5-10 minutes 10-20 minutes 10-15 minutes 10-15 minutes 10-15 minutes

Resuscitation procedure takes minimum of 4560minutes. Not including aftercare/ replacement of supplies/ coordination with ancillary department and postmortem.

Requisition of used medicines and supplies. Aftercare of all equipment and apparatus used. Postmortem Care NIGHT ROUTINE Changing of linens Disinfecting of all stretchers Disinfecting of all equipment Dusting Discharging Patients Prepares charges by transcribing on patients chart and prepare charge slip to be issued by the ER encoder. Ushers patient or accompanying person to the ER information Assists patient out of bed; assists patients in riding wheelchair or ushering out of ER. Instructs patient or accompanying person regarding payment of charges (location of cashiers) Coordination with HMO for approval of services given
D. Out-Patient Nurse (9:00am-5:00pm)

5-10 minutes 10-15 minutes 10-15 minutes 10-15 minutes 3-5 minutes 2-3 minutes 3-5 minutes 3-5 minutes 15-20 minutes

Summary was based on the activity of one (1) staff nurse assigned on OPS (9:00am- 500pm) from November 3-4, 2011. Activity (9:00am-5:00pm) Length of Time to Accomplish per nurse (minimum)

Checking of Chart Deficiencies at the Medical 15 minutes Records Checking and completing OPS Supplies 10-20 minutes Changing of OPS Linens/ Bed-Making 10-15 minutes Triaging/ Nurses Assessment 5 minutes per patient 4 minutes (1 minute per Vital signs taking VS) Retrieval of Old Chart/ Record for follow-up 3-5 minutes consultation Carrying-out of Out-patient Doctors orders/ Personnel Physicians Orders/ Admission Procedures at ER OB-Gyn (PER PATIENT) Requisition (pharmacy and ancillary services 3-5 minutes etc.) Retrieving requisitions (medicines and supplies 5-10 minutes

from the Pharmacy Coordination with the Ancillary departments. 3-5 minutes Coordination with HMO approval hotlines (if with 15-20 minutes HMO) (depending on case and HMO protocol) Preparation Medication 3-5 minutes/ medicine Giving of Medications (oral) 1-3 minutes/ medicine Giving Medications (IV) 3-5 minutes/ medicine Giving Medication (Nebulization) 3-5 minutes/ medicine Giving Medication (IM, SQ) 3-5 minutes/ medicine Skin Testing 3-5 minutes/ medicine Starting Oxygenation 1-3 minutes Foley Catheter insertion 15-20 minutes Straight Catheterization 15-20 minutes Preparing supplies for NGT insertion 3-5 minutes Assisting residents on duty in performing NGT 15-20 minutes insertion CBG taking 3-5 minutes I.V. insertion 10-15 minutes Starting I.V. Fluid/s /venoclysis Shifting I.V. Fluids 3-5 minutes Heplock insertion 5-10 minutes Assisting Surgery residents during minor 15-20 minutes surgical procedures. Preparation of Dressing Set 3-5 minutes Preparation of Minor Surgery Sets 3-5 minutes Washing of used instruments 5-10 minutes Charting 5-10 minutes Following-up of Laboratory results 3-5 minutes Transporting patient 3-5 minutes Endorsing patient/s to receiving unit 5-10 minutes Housekeeping after shift 10-20 minutes Discharging Patients Prepares charges by transcribing on patients 2-3 minutes chart. Ushers patient or accompanying person to the 2-3 minutes ER information Instructs patient or accompanying person regarding payment of charges (location of 3-5 minutes cashiers) Coordination with HMO for approval of services 15-20 minutes given RECORD KEEPING Recording of all patients record at the OPD 15-20 minutes Logbook.

Encoding of patients data in computer system 15-20 minutes (SOFTWORLD) Filing each chart on individual folders and filed in 15-20 minutes record cabinets. II. Nursing Assistant (Male) A. Morning Shift (6:00am-2:00pm) with one (1) aide on duty. Summary was based on the activities of two (2) male nursing assistant assigned on morning shift from November 3-5, 2011. Activity (6:00am-2:00pm) Housekeeping Tasks Turning-Off of all units air-conditioners Facilitates airing of the unit by opening all windows. Cleaning of all stretcher Checks availability of wheelchairs. Check availability of Oxygen tanks. Request and retrieve requested Oxygen tanks Prepares all instruments for autoclaving and regas. Delivers all properly packed instruments for autoclaving/ regas to the CSSR. Retrieve all autoclaved instruments and ambubags from the CSSR. Counts and drops all soiled linens at the Laundry. Delivers all requisitions for supplies to the Finance Office/ CPO Receives, counts arranges clean linens given by the Linen Department Inspect and reports unit fixtures for repair e.g. air-conditioner, fluorescent lights etc. Patient Care Lifting and Transferring of patients entering ER. Ushers wheeled/ stretcher-borne patients to the X-Ray/ CT-Scan/ Ultrasound etc. Sends urine/ stool/ other specimens to the laboratory Retrieve X-Ray/ CT Scan Plates Assist patient in minor nursing procedure e.g. Length of Time to Accomplish per nurse (minimum) 3-5 minutes 3-5 minutes 20-30 minutes 5-10 minutes 5-10 minutes 10-15 minutes 10-15 minutes 5-10 minutes 5-10 minutes 10-15 minutes 5-10 minutes 10-15 minutes 5-10 minutes 2-3 minutes 5-10 minutes 3-5 minutes 2-3 minutes 5-10 minutes

fleets/ cleansing enema, condom catheter placement etc. with nurses supervision Assist nurses in transporting admitted patients. Performs sponging Transport patients to doctors clinic at the MAB Bldg. Retrieves borrowed items/ equipment at the CSSR. Retrieve equipment needed during CODE e.g. E-Cart, Cardiac Monitor, Defibrillator etc. Performs CPR during Code with nurses supervision. Performs post-mortem care. Responsible in releasing cadaver from the morgue (cadaver from ER only) Assists discharged patients needing wheelchair/ stretcher.

5-10 minutes 10-15 minutes 3-5 minutes 3-5 minutes Immediately less than 1 minute CODE usually takes 30-45 minutes depending on case. 10-15 minutes 5-10 minutes 3-5 minutes

B. Broken shift (12:00pm-8:00pm) with one (1) aide on duty.

Activity (12:00pm-8:00pm) Housekeeping Tasks Prepares pack surgical towel and eye sheet for autoclaving Prepares and pack cotton balls for unit use. Check level of oxygen tanks Replaces empty oxygen tanks. Patient Care Assists in transporting patients to the Radiology Department for X-Ray, Ultrasound, CT Scan etc.

Length of Time to Accomplish per nurse (minimum) 15-20 minutes 15-20 minutes 5-10 minutes 10-20 minutes 10-15 minutes per patient depending on procedure 5-10 minutes per patient 3-5 minutes

Assists in transferring admitted patients to room of choice. Carries out nurses errands such as fetching supplies in the CSSR, CPO etc. Retrieves X-Ray/ CT Scan films in the Radiology 3-5 minutes Department. Assists other patients (not ER patients) going to 5-10 minutes per the Delivery Room, hemodialysis etc. patient CODE usually takes Assists nurses during CODE. 30-45 minutes depending on case.

Performs postmortem care Releases cadaver for pick-up Assists discharged patients needing wheelchair/ stretcher.

10-15 minutes 5-10 minutes 3-5 minutes

C. Afternoon shift (2:00pm-10:00pm) with one (1) aide on duty. Activity (2:00pm-10:00pm) Housekeeping Tasks Prepares other supplies for autoclaving/ regas. Prepares cotton balls for unit use Performs mopping of the floor Patient Care Assists in transporting patients to the Radiology Department for X-Ray, Ultrasound, CT Scan etc. Assists in transferring admitted patients to room of choice. Carries out nurses errands such as retrieving supplies in the CSSR, CPO etc. Delivers specimen/ urine sample to the laboratory Performs sponging as needed. Performs change of diapers to adult patients as needed. Performs change of hospital gown to male patients. Retrieves X-Ray/ CT Scan films in the Radiology Department. Assists other patients (not ER patients) going to the Delivery Room, hemodialysis etc. Assists nurses during CODE. Performs postmortem care Releases cadaver for pick-up Assists discharged patients needing wheelchair/ stretcher assistance.
III. Nursing Aide (Female): One (1) aide per shift.

Length of Time to Accomplish per nurse (minimum) 15-20 minutes 15-20 minutes 15-20 minutes 10-15 minutes per patient depending on procedure 5-10 minutes per patient 3-5 minutes 3-5 minutes 10-15 minutes 3-5 minutes 3-5 minutes 3-5 minutes 5-10 minutes per patient CODE usually takes 30-45 minutes depending on case. 10-15 minutes 5-10 minutes 3-5 minutes

Activity

Length of Time to Accomplish per nurse

Prayer/ Receiving of endorsement Checking of ER and HMO charges. Cleaning/ Dusting of tables, counters and equipments. Triaging (Chief Complaint taking, V/S taking,) Retrieval of Old Chart Approval of procedures/ requisitions for HMO patients. Dropping of Admission charges to the Finance Office. Transcribing patients data on ER-OPS Logbook Encoding patients data on computer system Filing of patients record Prepares census (daily/ monthly) Logging admissions on Admission Notebook Logging of HMO patients on HMO Notebook Patient Care V/S taking of Blood Donor Sponging of patient as needed. Change of diaper/ hospital gown V/ S taking as requested Preparing dressing set when requested. Washing of used surgical instruments including vaginal speculum) Performs other housekeeping such as bedmaking, washing of other equipments etc. Prepares and arranges office of the personnel physician Prepares OB-Gyn ER Transports patients to DR when male aide is not around. Prepares patients charges Assist discharged patients Endorses to incoming shift During Nightshift Thorough housekeeping such as disinfecting of stretcher bed mattresses, tables and counters, unit equipments etc. Changing of linens IV. ER Encoders/ Clerks: One (1) clerk per shift Activity

(minimum) 10-15 minutes 10-15 minutes 20-30 minutes 5 minutes/ patient 3-5 minutes 10-15 minutes/ HMO hotline 5-10 minutes 20-30 minutes 20-30 minutes 30 minutes 30 minutes 5-10 minutes 5-10 minutes 5 minutes/ patient 10-15 minutes 3-5 minutes 5 minutes 3-5 minutes 5-10 minutes 5-10 minutes 5-10 minutes 5-10 minutes 5-10 minutes 3-5 minutes 3-5 minutes 10-15 minutes 20-30 minutes 15-20 minutes Length of Time to Accomplish per nurse

Encodes requisitions of ER-Patients to Pharmacy, Laboratory, Radiology etc. Coordinates with ancillary department if needed for patients requisitions. Encodes requisitions of out-patients after Business Center closes (4:00pm onwards) Assists non-urgent/ emergent patients in filling up ER-OPS Forms. Assists patients for registration Coordinates with HMO hotlines for approval of requests. Prepares discharged patients charges (encodes to BIZBOX and issues charge slip). Encodes patients data on hospital system (BIZBOX/ SOFT WORLD) Prints Charges of HMO/ Cardholder and Admitted patients.

(minimum) 3-5 minutes/ patent 3-5 minutes 3-5 minutes/ patient 3-5 minutes/ patient 3-5 minutes/ patient 10-15 minutes 3-5 minutes 3-5 minutes/ patient 30-45 minutes

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