Safe Staffing Report - Arnot Ogden

1. Unit/Department *This question is required.

What is your unit/department?

2. Date for which you are reporting staffing: *This question is required.

3. Time for which you are reporting staffing:
Use 24-hour (military time) format, for example 0230 for 2:30am. *This question is required.

4. Total Number of Patients on Unit: *This question is required. This question requires a valid number format.

Number of ICU Staff on Duty:
(Please exclude staff that are currently being oriented or trained or who are unable to take a full assignment) *This question is required.

RN
Clinical Assistant

Number of 4B Staff on Duty:
(Please exclude staff that are currently being oriented or trained or who are unable to take a full assignment) *This question is required.

RN
Clinical Assistant

Number of 4D Staff on Duty:
(Please exclude staff that are currently being oriented or trained or who are unable to take a full assignment) *This question is required.

RN
Clinical Assistant

Number of 3B/3C Staff on Duty:
(Please exclude staff that are currently being oriented or trained or who are unable to take a full assignment) *This question is required.

RN
Clinical Assistant

Number of 5D Staff on Duty:
(Please exclude staff that are currently being oriented or trained or who are unable to take a full assignment) *This question is required.

RN
Clinical Assistant
LPN

Number of Maternity Staff on Duty:
(Please exclude staff that are currently being oriented or trained or who are unable to take a full assignment) *This question is required.

RN
Clinical Assistant

Number of Staff on Duty: *This question is required.

Space Cell	Job Title	# of Staff on Duty
	: Job Title	: # of Staff on Duty
	: Job Title	: # of Staff on Duty
	: Job Title	: # of Staff on Duty
	: Job Title	: # of Staff on Duty
	: Job Title	: # of Staff on Duty

Safe Staffing Report - Arnot Ogden

Arnot Ogden Staffing Report