You are the manager of a medical/surgical unit. Today is April 1, and the fiscal year began on July 1. You work with three types of budgets for your unit: personnel, operating, and capital. You have the opportunity to make changes to the current budgets based on the unit’s variance analysis. You cannot go over the total budgeted amount assigned to you. Your budget is presented below:

 Annual Budget Expended in March Expended Year to Date Amount Remaining 

Personnel $400,000 $30,000 $275,000 $125,000

Overtime $50,000 $2,000 $50,000 $0

Supplies $30,000 $3,500 $25,000 $5,000

Travel $1,000 $0 $300 $700

Equipment $6,000 $0 $6,000 $0

Staff Education $2,000 $300 $1,200 $800

Things you must consider as manager:

• A changing staffing pattern has been noted with a higher acuity on your unit. Your staff and

assistant managers are requesting more staff.

• The unit is starting a trial medication that requires the use of high-tech pumps. The risk management department has requested that these pumps be available before the trial begins so that staff are familiar with them. The trial medication is to begin in one month. Each pump costs $4,000 and with the volume of anticipated patients that will be receiving the medication, three pumps have been requested.

• You have noted that utilization of supplies has been increasing over the past two months,

 increasing the cost of supplies. With the increased usage of supplies, you note that there seems

 to be a direct correlation with an increased number of pressure injuries on the unit.

• A request has been made by three nurses to attend a pressure injury seminar at a two-day

conference in two months. The registration fee would be $400 per person. Projected total cost

for the conference is $1,800.

Your presentation should address the following:

• How will you address these requests based on the budget provided? 

• Which expenses would you defer to a new fiscal year? 

• How accurate were the budget projections? Which budgeting category was predicted most accurately and which was most inaccurate? 

• What budgeting methods can be used and how do they apply to this case? 

• What factors would need to be considered to calculate year to date variance for each category? What factors may have contributed to being over budget as determined by variance? 

• What steps can be taken in the 4th quarter to accommodate and adjust the budget?

 

Module Objectives 

Analyze how components of patient acuity and nurse staffing affect client care. 

Analyze planning and budgeting responsibilities of the nurse leader/manager including staffing, educational needs of the staff, and purchasing supplies. 

Identify continued education requirements and 

expectations of the professional nurse.  

Compare various methods of disseminating research 

evidence to nurses at the bedside. 

Topics Budget Basics 

Healthcare reimbursement 

Third-party reimbursements 

Fiscal planning and budgeting responsibilities 

Understanding staffing needs 

Nursing shortage and recruitment 

Educating and socializing new staff 

Staff development 

Dissemination of best practices

 

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