Throughout the United States, perioperative nurses and nurse leaders are being asked to provide more and better care with fewer resources. Building an annual budget with periodic monitoring is no longer sufficient. In today's healthcare environment, it is now necessary to conduct rolling budget reviews. Nurse leaders need to address unexpected changes, such as patient volume, acuity changes, and new technology requirements. Increased emphasis on efficiency and effectiveness in recent years has led to greater interest in evaluating the nursing workload of patient care and resource allocation. Prediction and justification of perioperative nurse staffing requirements, along with equipment and supply allocation to accurately provide sufficient patient care, are challenges. Given the evolving body of academic literature tying patient outcomes to specific nursing variables (for example, ratios, education, and experience), ORs and postanesthesia care units (PACUs) are tasked with balancing ideal investments in care quality with current nurse labor and supply constraints. As a large workforce, nurses make up the highest labor costs, and therefore, a large proportion of the hospital's budget.3 When staff and managers request more nursing capacity and additional supplies and equipment, they must be able to document and articulate the underlying increase in total nursing care workload as well as the added value and return on investment. OR nurses, PACU nurses, and nurse leaders need to understand patient needs, financial incentives, regulatory requirements, quality management, patient flow, census, and fluctuations to build sound budgets and effectively manage labor costs. In other words, perioperative nurse managers must learn how to speak the language of finance.
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