NURSE STAFFING UNDER DEMAND UNCERTAINTY TO REDUCE COSTS AND ENHANCE PATIENT SAFETY

2014 ◽  
Vol 31 (01) ◽  
pp. 1450005 ◽  
Author(s):  
ASHLEY DAVIS ◽  
SANJAY MEHROTRA ◽  
JANE HOLL ◽  
MARK S. DASKIN
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Patient Care ◽  
Demand Uncertainty ◽  
Nurse Staffing ◽  
Cost Savings ◽  
Staffing Level ◽  
Safe Patient Care ◽  
Demand Distribution ◽  
Using Data

Hospitals must maintain safe nurse-to-patient ratios in patient care units to offer adequate and safe patient care. Since the patient demand is highly variable, during high patient demand periods temporary or overtime nurses are hired to ensure safe nurse-to-patient ratios. These overtime nurses incur higher expense, and are often less effective. We study the problem of permanent nurse staffing level estimation under demand uncertainty as a newsvendor model. Our models are based on limited moment information of the demand distribution. Additionally, we introduce the use of asymmetric cost functions representing overstaffing and understaffing nursing costs. Findings using data from the general surgery and intensive care units at hospitals in Chicago, IL and Augusta, GA are presented. Computational results based on publically available cost data show that 3.1% and 7.3% annual cost savings result by introducing salvage value and newsvendor optimization in intensive care and general care units respectively. This new staffing scheme also improves patient safety as shifts are staffed with more permanent nurses.

scholarly journals In-Hospital Mortality in Patients Receiving Percutaneous Coronary Intervention According to Nurse Staffing Level: An Analysis of National Administrative Health Data

2020 ◽  
Vol 17 (11) ◽  
pp. 3799
Author(s):  
Yunmi Kim ◽  
Jiyun Kim
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Nurse Staffing ◽  
Coronary Intervention ◽  
First Grade ◽  
Estimation Model ◽  
Staffing Level ◽  
Percutaneous Coronary ◽  
General Wards

The increasing incidence of ischemic heart disease is concomitantly increasing percutaneous coronary intervention (PCI) treatments. Adequate nurse staffing has enhanced quality of care and this study was conducted to determine the relationship between survival-related PCI treatment and the level of nursing staff who care for patients admitted to receive PCI. National Health Insurance claims data from 2014 to 2015 for 67,927 patients who underwent PCI in 43 tertiary hospitals were analyzed. The relationships of nurse staffing in intensive care units (ICUs) and general wards with survival after PCI were investigated using logistic regression analyses with a generalized estimation model. The in-hospital mortality rate in ICUs was lower in hospitals with first-grade nurse staffing {odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.23–0.48}, second-grade nurse staffing (OR = 0.55, 95% CI = 0.40–0.77), or third-grade nurse staffing (OR = 0.71, 95% CI = 0.53–0.95) than in hospitals with fifth-grade nurse staffing. Nurse staffing in general wards was not related to in-hospital mortality due to PCI treatment. This study found that nurse staffing in PCI patients requiring short-term intensive care significantly affected patient survival. An understanding of the importance of managing the ICU nursing workforce for PCI treatment is required.

scholarly journals Intensive care unit procedures: cost savings and patient safety

Critical Care ◽  
10.1186/cc377 ◽  
1999 ◽  
Vol 3 (Suppl 1) ◽  
pp. P002
Author(s):  
NW Knudsen ◽  
MW Sebastian ◽  
RA Perez-Tamayo ◽  
WL Johanson ◽  
SN Vaslef
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Cost Savings

scholarly journals Competence in Patient Safety: A Multifaceted Experiential Educational Intervention for Resident Physicians

2011 ◽  
Vol 3 (3) ◽  
pp. 360-366 ◽  
Author(s):  
Michael P Lukela ◽  
Vikas I Parekh ◽  
John W Gosbee ◽  
Joel A Purkiss ◽  
John Del Valle ◽  
...  
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Faculty Attitudes ◽  
Learning Program ◽  
Improvement Project ◽  
Faculty Evaluations ◽  
Safe Patient Care ◽  
Safety Improvement ◽  
Care Processes ◽  
Comprehensive Survey

Abstract Background The need to provide efficient, effective, and safe patient care is of paramount importance. However, most physicians receive little or no formal training to prepare them to address patient safety challenges within their clinical practice. Methods We describe a comprehensive Patient Safety Learning Program (PSLP) for internal medicine and medicine-pediatrics residents. The curriculum is designed to teach residents key concepts of patient safety and provided opportunities to apply these concepts in the “real” world in an effort to positively transform patient care. Residents were assigned to faculty expert-led teams and worked longitudinally to identify and address patient safety conditions and problems. The PSLP was assessed by using multiple methods. Results Resident team-based projects resulted in changes in several patient care processes, with the potential to improve clinical outcomes. However, faculty evaluations of residents were lower for the Patient Safety Improvement Project rotation than for other rotations. Comments on “unsatisfactory” evaluations noted lack of teamwork, project participation, and/or responsiveness to faculty communication. Participation in the PSLP did not change resident or faculty attitudes toward patient safety, as measured by a comprehensive survey, although there was a slight increase in comfort with discussing medical errors. Conclusions Development of the PSLP was intended to create a supportive environment to enhance resident education and involve residents in patient safety initiatives, but it produced lower faculty evaluations of resident for communication and professionalism and did not have the intended positive effect on resident or faculty attitudes about patient safety. Further research is needed to design or refine interventions that will develop more proactive resident learners and shift the culture to a focus on patient safety.

What educational and other experiences assist recently qualified nurses to understand and deal with clinical risk and patient safety?

2021 ◽  
Author(s):  
◽  
Philip Charles Hawes
Keyword(s):  
Patient Safety ◽  
Clinical Practice ◽  
Learning Styles ◽  
Patient Care ◽  
Role Models ◽  
Clinical Environment ◽  
Contributing Factors ◽  
Clinical Role ◽  
Safe Patient Care ◽  
Clinical Risk

<p>This research was undertaken to investigate how newly graduated nurses recognise and develop skills relating to clinical risk and patient safety. I set out to understand how and where new graduates learn those skills and what would help future undergraduate nurses better prepare for the complexities of the clinical setting.  A qualitative research study using Appreciative Inquiry (AI) was the chosen methodology. This was selected for its aspirational outlook, which allows positive conclusions to be drawn from the study’s findings. Nine nurses in their first year of clinical practice participated in the study and they were interviewed on a one-to-one basis.  The key findings demonstrated that the approaches to teaching clinical risk and safe patient care and experiences of these in the undergraduate setting were variable, with many participants describing that they were ill prepared for the rigours of the clinical environment. They identified workplace culture, clinical role models, exposure to the clinical environment; experiential learning, narrative story sharing, debriefing and simulation as contributing factors to their ability to learn and understand clinical risk and safe patient care.  Despite their initial uncertainty, the participants were able to describe safe patient care and clinical risk. They identified cultures of safe patient care, safe teaching and safe learning. The participants further identified their preferred learning styles and recommended strategies that educationalists and clinical stakeholders employ to facilitate their professional development and understanding of clinical risk and patient safety.  The participants identified a more thoughtful, structured and overt approach to teaching the subject of clinical risk and patient safety to prepare for the clinical environment. They desired more experiential exposure, either clinical or simulated. They highlighted the need for effective preceptors and role models, alongside opportunities for sharing their clinical experiences and debriefing critical incidents. Furthermore, they recognised aspects of workplace cultures that facilitated or hindered effective clinical practice and safe patient care.</p>

SP5 A study exploring the opinions and attitudes of medical staff towards pharmacist independent prescribing in a neonatal intensive care unit

2018 ◽  
Vol 103 (2) ◽  
pp. e1.45-e1
Author(s):  
Williams Lauren ◽  
McIntosh Trudi
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Patient Care ◽  
Medical Staff ◽  
Neonatal Intensive Care ◽  
Positive Impact ◽  
List Type ◽  
Independent Prescribing

AimExisting published literature supports the implementation of pharmacist independent prescribing (PIP). A positive impact on patient care1 has been reported, with an encouraging response from patients2 and other healthcare professionals when asked about their views. There have also been reported patient safety benefits from PIP in secondary care.3 There is a gap in the literature regarding the utilisation of PIP in neonatal practice. The views of neonatal pharmacists across the UK towards PIP have been considered4 but to date there has been no research published on the opinions of medical staff about PIP in Neonatal Intensive Care Units (NICU). This study aimed to explore the opinions and attitudes of medical staff towards PIP in NICU, identifying any barriers and facilitators to the current service.MethodSemi-structured interviews were conducted with a purposively selected sample of senior registrars and consultants working within NICU. An interview schedule was developed, assessed for content validity and then piloted with two initial interviews (total interviews=10). Interviews were digitally recorded then transcribed verbatim. Framework Analysis principles were applied to data analysis. Ethics approval was granted by Robert Gordon University.ResultsParticipants displayed a positive attitude towards PIP, stating that it has been beneficial to the overall service provided in NICU. Improved patient safety, shared workload for medical staff and increased efficiency in prescribing were cited as important benefits. Collaborative working as a multi-disciplinary team when making prescribing decisions for the patient was noted to be essential, as was ensuring junior medical staff still receive the prescribing experience required for them to be competent prescribers. Although medical staff reported no concerns with PIP, lack of a service at weekends and PIP being limited by multiple concomitant ward rounds were identified barriers. The interpersonal skills and knowledge displayed by neonatal pharmacist prescribers, acceptance by the medical team and positivity towards new developments shown by all staff were highlighted as important facilitators.ConclusionAll participants were fully supportive of the PIP service provided in NICU. Utilising the knowledge and skills of pharmacist prescribers has improved the efficiency and quality of prescribing in the unit and has had a positive impact on patient care.ReferencesLatter S, Blekinsopp A, Smith A, et al. Evaluation of nurse and pharmacist independent prescribing 2010. London: University of Southampton. http://eprints.soton.ac.uk/184777/2/ENPIPexecsummary.pdf [accessed: 2016 August 17].Tinelli M, Blekinsopp A, Later S, et al. Survey of patients‘ experiences and perceptions of care provided by nurse and pharmacist independent prescribers in primary care. Health Expectations 2013;18:1241–1255.Baqir W, Crehan O, Murray R, et al. Pharmacist prescribing within a UK NHS hospital trust: Nature and extent of prescribing, and prevalence of errors. Eur J Hosp Pharm 2015;22:79–82.Mulholland PJ. Pharmacists as non-medical prescribers; what role can they play? The evidence in a neonatal intensive care unit. E J Hosp Pharm 2014;21:335–338.

scholarly journals The Effect of An Educational Program on Nurses’ Practices Regarding The Implementation of Patient Care and Safety Measures During Nasogastric Tube Feeding in The Critical Care Units in Syria

2021 ◽  
Vol 17 (29) ◽  
pp. 59
Author(s):  
Yaser Adnan Abo Jeesh ◽  
Elham Fath-Elalium Mohammed Khalid ◽  
Ishraqa Mohammed Ahmed Elbashier
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Intensive Care ◽  
Quality Of Care ◽  
High Risk ◽  
Patient Care ◽  
Educational Program ◽  
Safety Measures ◽  
Before And After

The intensive care unit (ICU) is considered a high- risk area in the hospital because of the severity of injuries and the high liability of occurrences associated with ICU. Critically ill patients are at high risk for actual or potential life-threating health problems. Moreover, critical care nurses must develop their knowledge, skills, and safe practice in acute areas where patients require more detailed observation or intervention to deliver safe and effective care. Objectives: This study aimed to assess the effect of an educational program on nurses’ practices regarding the implementation of patient care and safety measures during enteral feeding. Design: The quasi-experimental design was used in this study. Methods: The study was conducted from June to September 2020. All registered nurses who were working in the intensive care units during the period of data collection comprised the sample. Based on the nurses’ needs regarding the condition of their competencies during the initial assessment, we developed and designed the educational program. This program consists of two parts: theory and practical. The program contains workshop (8 hours) per day and educational pamphlet handout. The workshop consists of PowerPoint presentations, group discussions, and training scenarios. Results: This study was carried out with 48 nurses working in the previous intensive care units. The nurses’ score were improved after the program regarding to nurses’ age, qualification, and experience. The overall study found a statistically significant relationship of this procedure before and after the implementation of the educational program (p<0.001). Conclusion: There has been remarkable and variation improvement of nurses performance after they received the education program. The results show that a statistically significant difference was found before and after implementing the program regarding the nurses’ age, qualification, and experience. It is recommended to pay more attention to these nurses by helping them to improve their knowledge and practices in all nursing interventions. Furthermore, it is necessary to improve nurses’ awareness regarding the quality of care and patient safety. It was also found that the poor knowledge and practice and its complications have a negative impact on the quality of care and patient safety. 

scholarly journals Nurse Staffing in Intensive Care Units

1983 ◽  
Vol 11 (2) ◽  
pp. 118-124 ◽  
Author(s):  
G. D. Phillips ◽  
C. Chong ◽  
P. J. Gordon
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Teaching Hospital ◽  
Nursing Staff ◽  
Nurse Staffing ◽  
Staff Allocation ◽  
Hospital Intensive Care Unit ◽  
Care Requirements ◽  
Professional Judgement

Allocation of nursing staff to patient care in our teaching hospital Intensive Care Unit is based on providing the care considered necessary, bearing in mind the experience of the nursing staff and the care requirements of the patients. A detailed study of the nurse:patient ratio over a two month period has been carried out. It was found that there was considerable variation in both hours of care required and hours of care delivered from shift to shift. The study supported the principles used in staff allocation based on professional judgement, namely the acceptance of a high nurse: patient ratio, with other staff available for special duties, administration and education.

Sign in / Sign up

Export Citation Format

Share Document